摘要
报告1例毛发红糠疹样皮肌炎。患者女,62岁。患者1年前无明显诱因颈部、肩背部出现斑块及丘疹,后头部、双手、双膝部及足背也出现类似皮疹,2个月前无明显诱因出现四肢肌肉疼痛,并伴发热、关节疼痛入院。肌酶检查结果为天冬氨酸转氨酶61 IU/L(正常值10～45 IU/L,以下同),乳酸脱氢酶236 IU/L(100～230 IU/L),α-羟丁酸脱氢酶192 IU/L(72～182 IU/L)。肌电图为肌源性损害,时限短,多向波增多,插入性激惹,纤颤波等表现。肌肉组织病理表现为散在角状纤维和肌纤维变性,血管周围淋巴细胞浸润。灶性脂肪浸润和结缔组织间隔增厚。皮损组织病理检查示表皮角化过度,毛囊口角栓形成,棘层不规则肥厚,部分基底细胞液化,毛囊周围散在分布角化不全细胞,真皮内有淋巴细胞浸润。结合临床、肌电图、肌肉及皮损组织病理检查诊断为毛发红糠疹样皮肌炎。
A case of dermatomyositis presented as pityriasis rubra pilaris -like eruption is reported. A 62-year-old female patient presented with plaques and papules on the whole body for 1 year, and muscles pain for 2 months. Clinical examina- tion showed that there were plaques and papules on the neck, trunk, limbs, hands and feet. Some eruptions coalesced togeth- er but each had a clear boundary. Laboratory tests showed elevated muscle enzymes （AST, LDH, HBD）. EMG showed myoge- nous changes. Muscle biopsy showed diffuse degenerative changes in muscle fibers,perivascular lymphocytic infiltration,focal adipose infiltration, and thickening of connective septa. Histopathological examination of skin lesion showed hyperkeratosis of epidermis, horny plugs, irregular aeanthosis, focal liquefaction degeneration of basal ceils and parakeratotic cells scattered per- ifollicularly, and mild lymphocytic infiltration in the dermis. It was diagnosed as dermatomyositis with pityriasis rubra pilaris- like eruption according to the clinical, eleetromyographical, and histopathological changes of muscle and skin lesions.
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2012年第11期675-677,共3页
Journal of Clinical Dermatology
关键词
皮肌炎
毛发红糠疹
dermatomyositis
pityriasis rnbra pilaris
