以肿胀性红斑伴疼痛为首发表现的颜面播散性粟粒性狼疮

A case of lupus miliaris disseminatus faciei with swollen erythema and pain as the first manifestation

患者男,35岁。面部肿胀性红斑伴疼痛1个月,丘疹及结节半个月。皮肤科检查:额部、面颊、眶周及口周光滑质软的红褐色丘疹及结节对称分布,面部肿胀尤以眼周明显。皮肤镜检查:皮损中央可见数个靶样毛囊角栓。皮损组织病理检查:表皮萎缩,真皮浅层可见干酪样坏死灶,周围大量淋巴细胞等炎性细胞包绕,真皮深层多发结节状肉芽组织。诊断:颜面播散性粟粒性狼疮。治疗:口服甲泼尼龙等治疗后,皮损明显好转。

A case of lupus miliaris disseminatus faciei is reported.The patient,a 35-year-old male,had facial swollen erythema with pain for 1 month.Antiallergic treatment according to"facial dermatitis"was ineffective in the local hospital.Papules and nodules appeared on the basis of erythema half a month ago,which was diagnosed as lupus miliaris disseminatus faciei in the local traditional Chinese medicine hospital and was treated with herbal medicine,but there was no obvious effect.A diagnosis of lupus miliaris disseminatus faciei was made by histopathological examination in our hospital,and the skin lesions subsided significantly after treatment with oral methylprednisolone tablets and other drugs.