获得性反应性穿通性胶原病合并糖尿病

A case of acquired reactive perforating collagenosis with diabetes

报告1例获得性反应性穿通性胶原病合并糖尿病。患者女,53岁。四肢及躯干丘疹、结节及溃疡伴伴剧烈瘙痒半年。皮肤科检查:背部正中可见一浸润性紫红色肿块,全身散在分布大小不等的淡红色坚实丘疹、结节,中央凹陷,表面结痂。皮损组织病理检查:表皮呈杯形下陷,其内可见角化不全性碎屑、胶原变性及炎性细胞浸润。皮损两边棘层增厚,角栓底部菲薄,局部可见垂直穿通表皮的胶原蛋白。Masson三色染色及van Gieson染色示胶原组织向表皮穿通。诊断:获得性反应性穿通性胶原病合并2型糖尿病,背部痈。

A case of acquired reactive perforating collagenosis with diabetes is reported. A 53-year-old woman presented with papules, nodules, and severe pruritus on her extremities and trunk for half a year. Dermatological examination showed large infiltrative purplish erythema in the middle of the back, as well as solid papules and nodules of varying sizes with central depression and scab on the surface scattered around the body. Histopathological examination revealed that the epidermis had cup-shaped depression, in which there were hyperkeratotic debris, degenerative collagen and inflammatory cell infiltration. Thickened spinous layer on both sides of the lesion, thin angle plug base, and local collagen fibers penetrating through the epidermis could be observed. Masson trichrome staining and van Gieson staining showed that the collagen tissue penetrated the epidermis. The diagnosis of acquired reactive perforating collagenosis with diabetes was made.