文献简介

出版社:JAMA Dermatology

作  者:Enrique Rodríguez-Lomba, MD; Irene Molina-López, MD; Ofelia Baniandrés-Rodríguez, MD, PhD

编  号:

关键字:环状红斑;复发性半环状丘疹性红斑

年  份:2018   点击量:175

文献摘要 全文翻译

A healthy woman in her 50s presented with a large annular erythematous plaque on her lower back that had appeared in June (1 month previously) and had centrifugally expanded. She complained about mild pruritus that had not responded to conventional antihistamine therapy or topical steroids. She could not recall an arthropod bite prior to the skin eruption and denied having traveled outside Spain in the past few years. She reported a 20-year history of the same annular plaques recurring on the trunk every single year by the beginning of summer and spontaneously resolving by the beginning of autumn. Such lesions had never appeared on the face, hands, or feet. She did not relate these lesions to any particular hobby or application of any skin care product. Physical examination revealed a large,35-cmsemicircular erythematous plaqueonher lower back with central clearing and a distinctive, well-demarcated papular border (Figure, A and B). After obtaining informed consent, 2 biopsy specimens were taken from the papular border of the plaque for both hematoxylin-eosin stain and direct immunofluorescence (Figure, C).

患者女性,50余岁,既往体健,6月份(1个月前)时下背部出现一巨大环形红斑,呈离心扩张。患者自诉有轻度瘙痒感,且常规抗组胺药或局部类固醇治疗无效。患者不曾记得皮疹爆发前有被节肢动物咬伤,且几年内未有在西班牙以外地方旅游。她报告称,20年来每年夏初躯干反复出现相同的环状斑块,并在秋初自发消退。这些皮损未累及面部、手部或脚部。患者不认为这些皮损与任何特定爱好或任何护肤产品有关。体格检查显示,背部有一35厘米左右的环状红斑,中心消退,边界清晰(图A和B)。获得知情同意后,从丘疹斑块边缘取2个活检标本,用于HE染色和直接免疫荧光检查(图C)。