同时具有特应性皮炎样及肥厚性扁平苔藓样皮损的慢性移植物抗宿主病

发布时间：2018-11-09 13:58

【摘要】：报告1例同时具有特应性皮炎(AD)样及肥厚性扁平苔藓样皮损的慢性移植物抗宿主病(cGVHD)。患者男,22岁。因全身扁平丘疹伴皮肤干燥、瘙痒4个月就诊。2014年4月患者因急性淋巴细胞白血病行父供子人类白细胞抗原(HLA)7/10相合异基因造血干细胞移植术。皮肤科检查:全身皮肤干燥,毛发稀疏,面部色素沉着,躯干及四肢皮肤毛周隆起,散在紫红色肥厚性丘疹,口腔黏膜损害,甲板纵嵴。皮损组织病理检查:(背部结节)表皮角化亢进,角质层可见少量炎性细胞浸润,颗粒层及棘层不规则增厚,部分区域表皮突杵状下延,部分区域基底层液化变性;真皮浅层带状淋巴细胞浸润,可见噬黑素细胞,真皮小血管增生,内皮细胞肿胀。直接免疫荧光(-)。诊断:同时具有AD样及肥厚性扁平苔藓样皮损的cGVHD。
[Abstract]:A case of chronic graft-versus-host disease (cGVHD).) with atopic dermatitis and hypertrophic lichen planus lesions at the same time is reported. The patient was 22 years old. Patients with systemic flat papules with dry skin and pruritus for 4 months were treated with donor (HLA) 7 / 10 allogeneic hematopoietic stem cell transplantation for acute lymphoblastic leukemia in April 2014. Dermatology examination: dry skin, sparse hair, pigmentation of the face, skin around the trunk and limbs, scattered in purplish red hypertrophic papules, oral mucosal damage, deck longitudinal ridge. Histopathological examination of skin lesions: (back nodules) hyperkeratosis of epidermis, keratinocyte infiltration in keratinocytes, irregular thickening of granular layer and spinous layer, extension of pestle shape in part of epidermis, liquefaction of basal layer in part of area; The superficial layer of dermis was infiltrated with lymphocytes, melanocytes, microvascular hyperplasia and endothelial cells swelling. Direct immunofluorescence (-). Diagnosis: cGVHD. with both AD and hypertrophic lichen planus lesions
【作者单位】：山西省中医院皮肤科;孟村县医院皮肤科;北京大学人民医院皮肤科;
【分类号】：R758.2

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