文献简介

出版社:JAMA Dermatology

作  者:Divya Seth, MPH; Samson K. Kiprono, MBChB, MMed; Aileen Y. Chang, MD

编  号:

关键字:增殖性脓皮病;斑块

年  份:2018   点击量:191

文献摘要 全文翻译

A teenaged male presented with a 2-week history of vegetating, bleeding plaques and pustules on his face, scalp, trunk, and extremities. He reported that lesions began as pustules and developed into painful, itchy plaques. Before evaluation at a referral hospital in Kenya, the patient was treated with prednisolone tablet 5mg twice daily, clindamycin hydrochloride 300mg daily, and fluconazole 200mg daily, but he continued to develop new lesions. A complete review of systems was notable for the patient’s difficulty with walking because of skin lesions. On examination, pustules and hemorrhagic-crusted plaques were seen on the scalp, legs, arms, and trunk along with keloidal plaques on the face (Figure, A and B). Enzyme-linked immunosorbent assay testing for HIV was negative. A punch biopsy specimen from the arm was obtained for histopathologic study (Figure, C and D).

患者青年男性,面部、头皮、躯干和四肢出现增殖性出血斑块和脓疱2周就诊。患者自述皮损开始为脓疱后发展为疼痛、瘙痒斑块。在转诊肯尼亚医院进行评估之前,患者接受泼尼松龙片5mg(每日两次),每日300mg盐酸克林霉素,每日200mg氟康唑治疗,但新的皮损继续发展。值得注意的是完整系统评估示因皮肤损伤,患者行走困难。检查发现,患者头皮、腿、手臂和躯干可见脓疱和出血性结痂斑块,面部可见瘢痕斑块(图A和B)。HIV的酶联免疫吸附试验检测结果呈阴性。从手臂取钻孔活检标本用于组织病理学研究(图C和D)。