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NEJM：全身性环状肉芽肿合并糖尿病-案例报道

2016-09-09 MedSci MedSci原创

肉芽肿糖尿病炎症
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患者男性，64岁，全身躯干和肢体出现广泛性、对称性的红色或红棕色丘疹2年余（如图A）。  体格检查可见，丘疹融合成环状斑块，尤其是前臂和手的背侧表面皮肤（如图B）。  皮肤活检发现栅栏状肉芽肿性炎症，周围真皮内的胶原蛋白退化，这与肉芽肿的诊断一致。  实验室检查结果显示，空腹血糖水平为7.9mmol/l和餐后血糖12.1mmol/l，这一结果符合糖尿病的诊断标准

患者男性，64岁，全身躯干和肢体出现广泛性、对称性的红色或红棕色丘疹2年余（如图A）。  体格检查可见，丘疹融合成环状斑块，尤其是前臂和手的背侧表面皮肤（如图B）。皮肤活检发现栅栏状肉芽肿性炎症，周围真皮内的胶原蛋白退化，这与肉芽肿的诊断一致。实验室检查结果显示，空腹血糖水平为7.9mmol/l和餐后血糖12.1mmol/l，这一结果符合糖尿病的诊断标准。此外，甲状腺激素水平和血脂水平正常。环状肉芽肿是一种良性的、非感染性、肉芽肿性皮肤疾病，通常是表现为无症状性和自限性。通常，该疾病往往与局部和全身疾病相关，可以通过外伤、感染、药物和代谢紊乱引起发病。类似于本案例中的患者，表现出环状肉芽肿不常见的症状，它往往与糖尿病或甲状腺疾病存在一定的相关性。最后，该患者在医生的建议下，开始严格控制血糖，口服羟氯喹药物治疗，四个月后，其身上皮损现象明显消退，未留下疤痕。 原始出处： Menglong Ran, M.D., and Yang Wang, M.D. Generalized Granuloma Annulare Associated with Diabetes Mellitus&

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    2016-11-21 daviiliu

    #环状肉芽肿#

    0

  2. 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    2016-09-27 余越

    学习了额

    0

  3. 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    2016-09-16 lhl629

    学习了。。。

    0

  4. 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time=2016-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128322, encodeId=626812832261, content=学习了。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Fri Sep 16 06:08:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124876, encodeId=3e6b1248e6cb, content=学习了，赞一个！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Tue Sep 13 11:21:00 CST 2016, time=2016-09-13, status=1, 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likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sun Sep 11 19:41:00 CST 2016, time=2016-09-11, status=1, ipAttribution=)]
    2016-09-13 1dd8a7c5m95(暂无匿称)

    学习了，赞一个！！！

    0

  5. 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likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sun Sep 11 19:41:00 CST 2016, time=2016-09-11, status=1, ipAttribution=)]
    2016-09-12 1dd8a7c5m95(暂无匿称)

    学习了，赞一个！！！

    0

  6. 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likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sun Sep 11 19:41:00 CST 2016, time=2016-09-11, status=1, ipAttribution=)]
    2016-09-12 舒心和人

    各种并发症层出不穷，第一次见到，学习了，感谢分享

    0

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createdTime=Mon Sep 12 14:59:00 CST 2016, time=2016-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=123417, encodeId=96db12341ef6, content=学习了，赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Sep 12 12:10:00 CST 2016, time=2016-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=123053, encodeId=84421230534b, content=学习了，赞一个！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sun Sep 11 20:41:00 CST 2016, time=2016-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=122951, encodeId=ed4f12295153, content=学习了，赞一个！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sun Sep 11 20:30:00 CST 2016, time=2016-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=122802, encodeId=53be12280299, content=学习了，赞一个！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sun Sep 11 19:41:00 CST 2016, time=2016-09-11, status=1, ipAttribution=)]
    2016-09-12 虈亣靌

    学习了，赞一个

    0

  8. 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time=2016-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128322, encodeId=626812832261, content=学习了。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Fri Sep 16 06:08:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124876, encodeId=3e6b1248e6cb, content=学习了，赞一个！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Tue Sep 13 11:21:00 CST 2016, time=2016-09-13, status=1, 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likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sun Sep 11 19:41:00 CST 2016, time=2016-09-11, status=1, ipAttribution=)]
    2016-09-11 1dd8a7c5m95(暂无匿称)

    学习了，赞一个！！！

    0

  9. 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likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sun Sep 11 19:41:00 CST 2016, time=2016-09-11, status=1, ipAttribution=)]
    2016-09-11 1dd8a7c5m95(暂无匿称)

    学习了，赞一个！！！

    0

  10. 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    2016-09-11 1dd8a7c5m95(暂无匿称)

    学习了，赞一个！！！

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