文献简介

出版社:JAMA Dermatology

作  者:YulW. Yang, MD, PhD; Steven A. Nelson, MD; Shari A. Ochoa, MD,MS

编  号:

关键字:Lichen planus pigmentosus

年  份:2018   点击量:199

文献摘要 全文翻译

A 62-year-old woman with a history of rosacea and melasma presented with worsening gray-brown patches on the face. One year prior to presentation, the patient had a facial rash characterized by redness, burning, and minimal pruritus. The rash subsequently improved but resulted in dark patches covering the forehead, cheeks, and neck. She intermittently continued to experience mild facial erythema. No oral or other cutaneous lesions were reported. She previously tried topical tacrolimus, triamcinolone, flurandrenolide, azelaic acid, intermittent hydroquinone, and glycolic acid peels. Other than asthma treatment, she denied any significant history of systemic medications. Examination showed diffuse gray-brown mottled hyperpigmented patches at the forehead, cheeks, and neck, sparing the central face, with focal red, poorly demarcated patches at the medial cheeks and glabella (Figure 1A). Close examination and dermoscopy showed blue-gray dots arranged in circles (Figure 1B). A punch biopsy specimen was obtained (Figure 1C).

患者女性,62岁,有酒糟鼻和黄褐斑病史,因面部灰褐色斑块恶化就诊。一年前,患者面部皮疹特点为发红、有烧灼感和轻度瘙痒。皮疹随后改善,但前额、面颊和颈部出现黑斑。患者面部间歇性出现轻度红斑。未报道口腔或其他皮肤出现皮损。患者曾尝试局部他克莫司、曲安奈德、丙酮缩氟氢羟龙、壬二酸、间歇性氢醌治疗和乙醇酸剥脱治疗。除哮喘治疗外,患者否认有显著系统性用药史。检查显示前额、脸颊、颈部(未累及面部中心)可见弥漫性灰褐色色素沉着斑,伴局部发红,在内侧脸颊和眉间有明显的斑块(图1A)。仔细检查和皮肤镜检查可见呈圆形分布的蓝灰色点(图1B)。取穿刺活检标本(图1C)。