以周身水肿性红斑为早期表现的硬斑病1例

A Case of Morphea with Early Manifestation of Peripheral Edematous Erythema

66岁女性患者,周身红斑6个月,伴痒1个月。6月前无明显诱因周身出现红斑,无明显症状,未到医院就诊,周身红斑逐渐增多。自行外用吡美莫司乳膏、多磺酸粘多糖乳膏治疗约2月,红斑颜色较前稍变淡,皮疹仍有新发。行组织病理检查示:表皮萎缩,基底层色素增加,真皮血管周围可见灶状以淋巴细胞为主的炎症细胞浸润,有时可见浆细胞及嗜酸性粒细胞,真皮网状层与皮下组织交界处可见小灶状淋巴细胞及浆细胞浸润,真皮网状层胶原束增厚。诊断:硬斑病。

A 66-year-old female patient presented with erythema for 6 months and itching for 1 month.6 months ago,without obvious symptoms,she developed erythema all over her body without obvious symptoms.Without going to the hospital,the erythema gradually increased.Pimecrolimus cream and mucopolysaccharide polysulfate cream were used for external use for about 2 months.The erythema color was slightly lighter than before,and there were still new rashes.Histopathological examination showed epidermal atrophy,increased pigmentation in the basal layer,focal infiltration of inflammatory cells dominated by lymphocytes around the dermal vessels,sometimes plasma cells and eosinophils,small focal infiltration of lymphocytes and plasma cells at the junction of the reticular layer and subcutaneous tissue,and thickening of collagen bundles in the reticular layer of the dermis.The patient was diagnosed as morphea.