文献简介

出版社:JAMA

作  者:CristianNavarrete-Dechent,MD;KlausJ.Busam,MD;AlinaMarkova,MD

编  号:

关键字:红斑;血管肉瘤

年  份:2020   点击量:90

文献摘要 全文翻译

A man in his 80s with a pacemaker; a history of congestive heart failure, coronary artery disease, atrial fibrillation, transient ischemic attack, and Parkinson disease; and dependence in all activities of daily living presented to the dermatology department with a 4-month history of new-onset persistent facial eruption. He denied a history of facial flushing. The patient was initially treated for rosacea at an outside hospital with topical 1% metronidazole cream for 1 month without improvement and developed acute facial purpura after 1 day of treatment with oral doxycycline, which was discontinued. Because of the eruption’s rapid onset and violaceous appearance, as well as empirical treatment failure, the patient was referred for further evaluation. On examination, the patient had asymmetric, centrofacial, erythematous-violaceous indurated telangiectatic and ecchymotic plaques over a phymatous background (Figure, A). A series of punch biopsies were performed (Figure, B-D).

患者男性,80余岁,安放有起搏器;有充血性心力衰竭、冠状动脉疾病、房颤,短暂性脑缺血发作和帕金森病病史;且日常所有活动依赖于皮肤科医生,并有4个月新发持续性面部丘疹史。患者否认面部发红病史。该患者最初院外局部1%甲硝唑乳膏治疗酒渣鼻,但治疗1个月后无改善,口服强力霉素治疗1天后出现急性面部紫癜,停用该药。由于皮损(外观呈紫红色)快速发展,以及经验治疗失败,因此将患者转诊进行进一步评估。检查发现患者中心面部有不对称红斑-紫罗兰色硬化毛细血管扩张和瘀斑(图A)。进行了一系列穿刺活检(图B-D)。