坏疽性脓皮病合并类白血病反应1例

Pyoderma gangrenosum with leukemoid reaction:report of one case

患者男,17岁,双下肢反复疼痛溃疡3年。本次复发前无明显诱因出现高热,双胫前出现丘脓疱疹,疼痛,范围迅速扩大,并破溃形成溃疡。结合临床表现及组织病理改变,诊断为坏疽性脓皮病。外周血显示白细胞高达114×109/L,血小板低至1.9×109/L,同时伴有贫血,经骨髓涂片、中性粒细胞碱性磷酸酶积分以及对治疗的反应,证实该患者为坏疽性脓皮病并发类白血病反应。

A17 - year - old boy presented recurrent painful ulcers on the shins for three years.Before the last relapse,there was high fever,painful papulopustules appeared on both pretibial areas,the lesion enlarged rapidly and ulcerated.A diagno-sis of pyoderma gangrenosum was established according to the clinical manifestations and histopathologic changes.Blood cell count showed leukocyto sis(114×10 9 /L),thrombocytopenia(1.9×10 9 /L)and anemia.Bone marrow smear,score of neutrophil al-kaline phosphatase(NAP)and the treatment effects proved the patient had secondary leukemoid reaction.