发热型溃疡型急性痘疮样苔藓样糠疹合并肝炎和肺真菌感染1例

发布时间：2018-01-28 23:56

本文关键词： 痘疮样糠疹溃疡坏死性发热性　出处：《中国皮肤性病学杂志》2017年11期 　论文类型：期刊论文

【摘要】：患者男,34岁,躯干红斑、丘疹半月余,泛发全身10d。皮损为密集分布的大小不一的红斑、丘疹,部分红斑、丘疹上可见米粒大小的水疱及浅溃疡和暗黑色痂,水疱疱液清,壁厚,尼氏征阴性。躯干见散在色素沉着斑,无明显脓疱、糜烂、渗液。皮损组织病理示:表皮角化不全伴少许炎细胞浸润,表皮内和真皮浅层广泛红细胞外渗,表皮细胞内和细胞间水肿伴变性、坏死,部分棘层松解,表皮和真皮浅层界限模糊不清,真皮浅、中层小血管周围致密淋巴细胞、组织细胞浸润。乙肝表面抗原、乙肝e抗原、乙肝核心抗体三项阳性。诊断:发热型溃疡型急性痘疮样苔藓样糠疹。服用强的松1个月后,患者行支气管镜检查刷片示真菌孢子阳性,痰培养示白色念球菌,予氟康唑胶囊治疗2周后症状好转。
[Abstract]:The patient was 34 years old with erythema on the trunk, papules for more than half a month, and had generalized systemic lesions for 10 days. The lesions were densely distributed erythema of different sizes, papules, and part of erythema. The pustular fluid was clear, the wall thickness was clear, and the Nissl sign was negative. The trunk was scattered in pigmented spots with no obvious pustules and erosion. Exudate. Histopathology of the lesions showed that the keratosis of epidermis was accompanied by a few inflammatory cells infiltration, extensive exosmosis of erythrocytes in epidermis and dermis, edema in and between epidermis cells with degeneration, necrosis, and partial release of spinous layer. The superficial boundary of epidermis and dermis is blurred, the dermis is shallow, tight lymphocytes around small vessels in middle layer, tissue cells infiltrate, hepatitis B surface antigen, hepatitis B e antigen. Hepatitis B core antibody positive. Diagnosis: febrile ulcer type of acute aphrodisiform lichen lichen furfural. After taking prednisone for 1 month, the patients were examined by bronchoscopy to show positive fungal spores, and sputum culture showed Candida albicans. The symptoms of fluconazole capsule were improved 2 weeks after treatment.
【作者单位】：成都市第二人民医院皮肤科;
【分类号】：R519;R575;R758.6
【正文快照】： 1临床资料患者男,34岁,躯干红斑、丘疹半月余,泛发全身10d。半月前患者躯干开始出现红斑、丘疹,无瘙痒等不适,未予重视。10d前上述皮疹泛发全身,部分红斑上出现水疱,部分破溃后形成溃疡、结痂,伴发热,热型不规则,体温38℃~39.5℃,无畏寒、乏力等不适。患者于当地医院就诊,予“

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