中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
7期
1075-1079
,共5页
肉芽肿%环状%播散型
肉芽腫%環狀%播散型
육아종%배상%파산형
Granulona%Annulare%Generalized
目的 探讨播散型环状肉芽肿(GGA)的临床表现、组织病理特征、治疗方法及预后.方法 对4例GGA的临床表现、组织病理改变、治疗方法及预后进行回顾性研究,并对近年GGA的国内外文献进行了回顾.结果 4例患者,男女各2例,年龄42～ 72岁,以全身丘疹为主诉就诊.病程3个月至1年不等.3例曾误诊.4例GGA表现为躯干、四肢及颈部泛发肤色或红色丘疹、斑丘疹,部分损害中央可见脐凹,边缘呈环状.3例组织病理检查均示真皮浅中层胶原黏液变性,周围淋巴细胞、组织细胞呈栅状排列.1例示真皮浅中层胶原排列紊乱,胶原轻度变性,胶原束间可见散在分布的淋巴细胞、组织细胞及少量多核巨细胞.4例患者均接受了糖皮质激素制剂局部治疗,系统治疗分别为抗组胺药物、糖皮质激素、羟氯喹、异维A酸及补骨脂素紫外线疗法治疗.患者治疗后根据用药及患者治疗反应情况,不定期随诊.根据皮损数量和瘙痒程度变化判断疗效.随访6～35个月,平均随访(26±14)个月.2例患者治愈,随访2年无复发,1例有效,1例无效.结论 GGA相对少见,容易误诊,临床需要注意寻找脐凹样或环状损害改变的特征性表现.组织病理特征为栅状肉芽肿或弥漫性淋巴组织细胞浸润伴胶原变性.糖皮质激素、羟氯喹治疗及光化学疗法治疗有一定疗效.
目的 探討播散型環狀肉芽腫(GGA)的臨床錶現、組織病理特徵、治療方法及預後.方法 對4例GGA的臨床錶現、組織病理改變、治療方法及預後進行迴顧性研究,併對近年GGA的國內外文獻進行瞭迴顧.結果 4例患者,男女各2例,年齡42～ 72歲,以全身丘疹為主訴就診.病程3箇月至1年不等.3例曾誤診.4例GGA錶現為軀榦、四肢及頸部汎髮膚色或紅色丘疹、斑丘疹,部分損害中央可見臍凹,邊緣呈環狀.3例組織病理檢查均示真皮淺中層膠原黏液變性,週圍淋巴細胞、組織細胞呈柵狀排列.1例示真皮淺中層膠原排列紊亂,膠原輕度變性,膠原束間可見散在分佈的淋巴細胞、組織細胞及少量多覈巨細胞.4例患者均接受瞭糖皮質激素製劑跼部治療,繫統治療分彆為抗組胺藥物、糖皮質激素、羥氯喹、異維A痠及補骨脂素紫外線療法治療.患者治療後根據用藥及患者治療反應情況,不定期隨診.根據皮損數量和瘙癢程度變化判斷療效.隨訪6～35箇月,平均隨訪(26±14)箇月.2例患者治愈,隨訪2年無複髮,1例有效,1例無效.結論 GGA相對少見,容易誤診,臨床需要註意尋找臍凹樣或環狀損害改變的特徵性錶現.組織病理特徵為柵狀肉芽腫或瀰漫性淋巴組織細胞浸潤伴膠原變性.糖皮質激素、羥氯喹治療及光化學療法治療有一定療效.
목적 탐토파산형배상육아종(GGA)적림상표현、조직병리특정、치료방법급예후.방법 대4례GGA적림상표현、조직병리개변、치료방법급예후진행회고성연구,병대근년GGA적국내외문헌진행료회고.결과 4례환자,남녀각2례,년령42～ 72세,이전신구진위주소취진.병정3개월지1년불등.3례증오진.4례GGA표현위구간、사지급경부범발부색혹홍색구진、반구진,부분손해중앙가견제요,변연정배상.3례조직병리검사균시진피천중층효원점액변성,주위림파세포、조직세포정책상배렬.1례시진피천중층효원배렬문란,효원경도변성,효원속간가견산재분포적림파세포、조직세포급소량다핵거세포.4례환자균접수료당피질격소제제국부치료,계통치료분별위항조알약물、당피질격소、간록규、이유A산급보골지소자외선요법치료.환자치료후근거용약급환자치료반응정황,불정기수진.근거피손수량화소양정도변화판단료효.수방6～35개월,평균수방(26±14)개월.2례환자치유,수방2년무복발,1례유효,1례무효.결론 GGA상대소견,용역오진,림상수요주의심조제요양혹배상손해개변적특정성표현.조직병리특정위책상육아종혹미만성림파조직세포침윤반효원변성.당피질격소、간록규치료급광화학요법치료유일정료효.
Objective To investigate the clinical and pathological features of generalized granuloma annulare.Methods Retrospective study on clinical manifestations,histopathological changes,treatment and prognosis of 4 cases of generalized granuloma annulare was performed.Results Four patients included two males and two females with the chief complaint of disseminated papules,arciform and annular appearance.The eruption was distributed to extremities,neck and trunk.Duration was from 3 months to 1 year.Histopathology of 3 cases showed degenerated collagen surrounded by lymphocytes with histocytes in middle dermis.Another case showed disorder of collagen with sparsely arranged lymphocytes,histocytes and a few multinucleated cells.The degeneration of collagen was very mild.All patients received topical cortisone treatment.Systemic treatments were as follows:anti-histamine medicine,cortisone,chloroquine,isotretinoin and photochemotherapy (psoralen + ultraviolet A,PUVA).The patients were followed irregularly according to treatment and the response to the treatment.Efficiency of treatment was evaluated by the change of lesions and pruritus.Follow-up was 6-35 months with average (26 ±14) months.2 patients were cured without recurrence for more than 2 years.One patient was improved.The last patient was failed to treatment with eruptions developed.Conclusions Generalized granuloma annulare is not a common diseases and easy to be misdiagnosed.Typical clinical features are arciform and annular papules or plaques.Histopathology shows palisadic granulama or interstitial infiltrate of histocytes and lymphocyte with collagen degenerated.Some cases response to cortisone,chloroquine and PUVA.
