中华皮肤科杂志
中華皮膚科雜誌
중화피부과잡지
Chinese Journal of Dermatology
2009年
12期
807-809
,共3页
王震英%徐秀莲%刘季和%孙建方
王震英%徐秀蓮%劉季和%孫建方
왕진영%서수련%류계화%손건방
角化不全%透明素%病理学
角化不全%透明素%病理學
각화불전%투명소%병이학
Parakeratosis%Hyalin%Pathology
患者女,31岁,左腋窝红斑、糜烂、痒23年.体检:左腋下可见近环形红色斑片,约8 cm×10 cm,皮损中央淡紫红色粟粒大棘状丘疹,不完全融合形成斑块,皮损外周红斑表面轻度糜烂、渗液,散在少量米粒大脓疱,部分区域可见瘢痕;全身其他间擦部位未见任何皮损.皮损表面分泌物真菌镜检阴性.组织病理:角质层增厚,角化过度并显著角化不全,角质层大多数细胞保留细胞核,包含大量嗜碱性颗粒.角化不全下方颗粒层仍然保留,其中少部分细胞胞质呈空泡状.表皮呈银屑病样增生,真皮内血管周围以淋巴细胞为主的混合炎症浸润,并可见明显血管扩张.诊断:颗粒状角化不全.
患者女,31歲,左腋窩紅斑、糜爛、癢23年.體檢:左腋下可見近環形紅色斑片,約8 cm×10 cm,皮損中央淡紫紅色粟粒大棘狀丘疹,不完全融閤形成斑塊,皮損外週紅斑錶麵輕度糜爛、滲液,散在少量米粒大膿皰,部分區域可見瘢痕;全身其他間抆部位未見任何皮損.皮損錶麵分泌物真菌鏡檢陰性.組織病理:角質層增厚,角化過度併顯著角化不全,角質層大多數細胞保留細胞覈,包含大量嗜堿性顆粒.角化不全下方顆粒層仍然保留,其中少部分細胞胞質呈空泡狀.錶皮呈銀屑病樣增生,真皮內血管週圍以淋巴細胞為主的混閤炎癥浸潤,併可見明顯血管擴張.診斷:顆粒狀角化不全.
환자녀,31세,좌액와홍반、미란、양23년.체검:좌액하가견근배형홍색반편,약8 cm×10 cm,피손중앙담자홍색속립대극상구진,불완전융합형성반괴,피손외주홍반표면경도미란、삼액,산재소량미립대농포,부분구역가견반흔;전신기타간찰부위미견임하피손.피손표면분비물진균경검음성.조직병리:각질층증후,각화과도병현저각화불전,각질층대다수세포보류세포핵,포함대량기감성과립.각화불전하방과립층잉연보류,기중소부분세포포질정공포상.표피정은설병양증생,진피내혈관주위이림파세포위주적혼합염증침윤,병가견명현혈관확장.진단:과립상각화불전.
A case of granular parakeratosis is reported. A 31-year-old woman presented with a 23-year history of pruritic erythema and erosion in the left axilla. On examination, there was a ring-like annular erythematous patch sized 8 cm×10 cm in the left axilla. Bright mauve, cone-shaped, millet-like papules were observed in the center of the lesion, some confluenced into plaques. Erythema was present in the pedlesional region along with mild erosion, exudation and small numbers of grain-sized pustules. Scar formed in some perilesional areas. No lesions were noted at any other intertriginous regions. Fungal microscopy of lesion secretions was negative. Histological examination of biopsy specimens from the center of the left axilla revealed psoriasiform hyperplasia of epidermis and thickened stratum comeum with hyperkeratosis and parakeratosis. Most cells in the stratum comenm retained nuclei and contained numerous basophilic granules. Granular layer could be noted under the parakeratotic cells with cytoplasm vacuolization of some cells. There was a perivascular, mixed inflammatory infiltration predominated by lymphocytes and hemangiectasis in the dermis. A diagnosis of granular parakeratosis was made.