单侧肉芽肿性玫瑰痤疮1例国内首报

Unilateral Granulomatous Rosacea:the First Case Reported in China

患者男,40岁,左面部红斑、丘疹、脓疱1年。皮肤科情况:左面部散在红斑及粟粒至绿豆大小丘疹、脓疱,部分融合成片,右面部未受累。皮损组织病理示:表皮灶状角化不全,棘层不规则增生,真皮全层弥漫性混合炎细胞浸润,可见蠕形螨、中性粒细胞小脓肿及上皮样肉芽肿形成。PAS染色、六胺银染色及抗酸染色均为阴性。诊断:单侧肉芽肿性玫瑰痤疮。治疗及随访:予盐酸米诺环素胶囊,50 mg, 2次/d等治疗2个月后,皮损较前缓解。

A 40-year-old male presented with erythema,papules,and pustules on the left side of the face for 1 year.Skin examination showed scattered erythema,miliary to mungbean sized papules and pustules on the left face,part of which were fused into pieces,but the right face was not involved.The histopathology examination showed focal parakeratosis of the epidermis,irregular proliferation of the spinous layer,and diffuse infiltration of mixed inflammatory cells in the whole dermis.Demodex mites,neutrophil abscesses,and epithelioid granulomas could be seen.PAS staining,hexamine silver staining,and acid-fast staining were negative.The diagnosis of unilateral granulomatous rosacea was established.After 2 months of treatment with minocycline hydrochloride capsules(50 mg,2 times per day),the lesions were relieved.