儿童皮病性淋巴结炎的临床特点及病理特征

Clinical and Pathological Characteristics of Dermatopathic Lymphadenitis in Childhood

【目的】探讨儿童时期发病的皮病性淋巴结炎(DL)的临床特点及病理特征。【方法】回顾性分析2020年3月至6月本院疑难综合病房收治的2例DL患儿,分析DL患儿的临床特点及病理特征,并进行文献复习。【结果】2例DL患儿均以反复发热、淋巴结肿大为首发症状,经抗感染治疗效果欠佳,入院后出现全身皮疹,且以腹股沟淋巴结肿大为主。患儿1临床表现疑似组织细胞坏死性淋巴结炎,经病理检查最终诊断为DL,给予激素治疗,患儿体温逐渐稳定,皮疹逐渐消退。患儿2最终诊断为幼年特发性关节炎合并DL,予以激素及托珠单抗治疗后体温逐渐恢复正常,皮疹消退。【结论】2例患儿为国内罕见的儿童DL,且以反复发热、淋巴结肿大(腹股沟为主)为首发症状,随后伴有皮肤改变,病理改变为非特异性淋巴结反应性增生。

【Objective】To investigate the clinical and pathological characteristics of dermatopathic lymphadenitis(DL)in childhood.【Methods】The clinical and pathological characteristics of 2 children with DL admitted in the difficult and complicated comprehensive ward of our hospital from March to June 2020 were analyzed retrospectively,and the literature was reviewed.【Results】Repeated fever and lymphadenectasis were the first symptoms of 2 children with DL,and the effect of anti infection treatment was not good.Systemic rash occurred in the course of the disease after admission,and the main symptom was inguinal lymphadenectasis.The clinical manifestation of child 1 was similar to histiocytic necrotizing lymphadenitis,which was finally diagnosed as dermatopathic lymphadenitis by pathological examination.After hormone treatment,the child's temperature gradually stabilized and the rash gradually subsided.Child 2 was finally diagnosed as juvenile idiopathic arthritis with DL.After treatment with hormone and tropizumab,his temperature gradually became normal and his rash subsided.【Conclusion】Two cases of children with lymphadenitis due to dermatosis were rare in China,and the first symptom was repeated fever,lymphadenopathy(mainly inguinal),followed by skin changes,and the pathological change was non-specific reactive hyperplasia of lymph nodes.