色素异常性皮肤淀粉样变性

2018-03-24 佚名 临床皮肤科杂志

患者男,53岁。

【一般资料】

患者男,53岁。

【主诉】

因全身皮肤色素异常伴瘙痒45年就诊。

【现病史】

患者8岁起无明显诱因躯干及四肢出现散在分布粟粒大白色及少量褐色斑点,双下肢胫前出现粟粒大丘疹,散在分布,躯干、四肢均瘙痒明显,未曾发生水疱,无光过敏史。45年来躯干及四肢皮损面积及下肢胫前丘疹随着年龄增长逐渐增多、增大,未诊治。

【既往史】

患者既往体健,否认慢性病史、传染病史,无手术、外伤史及输血史。

【家族史】

家族成员中无类似疾病患者。

【体格检查】

发育正常,无身材矮小,各系统检查无异常。皮肤科检查:躯干、四肢混杂的色素沉着与色素减退斑(图1),无皮肤萎缩、水疱及鳞屑,无毛细血管扩张,黏膜部位及手、足无异常,双小腿胫前密集分布褐色角化过度性丘疹,质地硬,皮损之间不融合。





【辅助检查】

血、尿常规,胸部X线片均正常。皮损组织病理检查:表皮角质层呈网栏状角化过度,基底层黑素细胞增多,色素颗粒增多,真皮乳头层可见均质状嗜伊红物质沉积,真皮浅层血管周围有少量炎性细胞浸润(图2A);刚果红染色示表皮角化过度,基底层大量黑素细胞,真皮乳头层可见均一红染物质沉积,真皮浅层可见炎性细胞浸润(图2B)。

【初步诊断

色素异常性皮肤淀粉样变性。

【治疗】

由于本病难治,告知患者瘙痒时可口服西替利嗪10mg每日1次,外用卤米松软膏等对症治疗。

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    2019-01-27 sunylz
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    2018-03-26 huangdf
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    2018-03-24 天地飞扬

    了解一下.谢谢分享!

    0

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    2018-03-24 sunfeifeiyang

    0

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