坏死松解性肢端红斑一例

doi:10.3760/cma.j.issn.0412-4030.2019.09.003

中华皮肤科杂志 ›› 2019, Vol. 52 ›› Issue (9): 604-606.doi: 10.3760/cma.j.issn.0412-4030.2019.09.003

坏死松解性肢端红斑一例

储开宇¹ 莫惠芳¹ 王键旋¹ 毛荣军²

¹佛山市中医院皮肤科，广东 528000；²佛山市中医院病理科，广东 528000

收稿日期:2018-12-13 修回日期:2019-06-23 出版日期:2019-09-15 发布日期:2019-08-30
通讯作者: 储开宇 E-mail:chukaiyu126@126.com

A case of necrolytic acral erythema

Chu Kaiyu¹, Mo Huifang¹, Wang Jianxuan¹, Mao Rongjun²

¹Department of Dermatology, Foshan Hospital of TCM, Foshan 528000, Guangdong, China; ²Department of Pathology, Foshan Hospital of TCM, Foshan 528000, Guangdong, China

Received:2018-12-13 Revised:2019-06-23 Online:2019-09-15 Published:2019-08-30
Contact: Chu Kaiyu E-mail:chukaiyu126@126.com

摘要/Abstract

摘要： 【摘要】患者女，25岁，双足部皮疹伴瘙痒10年。皮肤科情况：双足趾背及邻近足背、右踝伸侧、左跟腱可见边界清楚的暗红色斑块，上覆灰褐色鳞屑。实验室检查：血清丙型肝炎抗体阴性，丙型肝炎病毒核酸定量正常。右侧足背皮损组织病理：表皮角化过度伴角化不全，棘层不规则增生，棘层中上部散在角化不良细胞和坏死角质形成细胞，基底细胞局灶性液化变性；真皮浅中层小血管扩张，周围少量淋巴细胞浸润。诊断：不伴丙型肝炎的坏死松解性肢端红斑。治疗2个月后皮疹完全消退，遗留色素沉着。

关键词: 丙型肝炎, 松解坏死型游走性红斑, 坏死松解性肢端红斑

Abstract: 【Abstract】 A 25-year-old female patient presented with itchy rashes on her feet for 10 years. Skin examination showed dark red plaques with clear boundaries, whose surfaces were covered with grey-brown scales, on the dorsum of toes and adjacent dorsum of the feet, the extensor aspect of the right ankle and the left Achilles tendon. Laboratory tests revealed that serum anti-hepatitis C virus （HCV） antibody was negative and HCV-RNA quantity was normal. Histopathological examination showed epidermal hyperkeratosis with parakeratosis, irregularly thickened spinous layer, scattered dyskeratotic cells and necrotic keratinocytes in the middle and upper spinous layer, focal liquefaction degeneration of basal cells, dilatation of small blood vessels in the superficial and middle dermis, and perivascular infiltration of a small number of lymphocytes. The patient was diagnosed with necrolytic acral erythema without hepatitis C. After 2-month treatment, the skin lesions completely regressed, and hyperpigmentation remained.

Key words: Hepatitis C, Necrolytic migratory erythema, Necrolytic acral erythema

储开宇莫惠芳王键旋毛荣军. 坏死松解性肢端红斑一例 [J]. 中华皮肤科杂志, 2019, 52(9): 604-606.doi:10.3760/cma.j.issn.0412-4030.2019.09.003

Chu Kaiyu, Mo Huifang, Wang Jianxuan, Mao Rongjun. A case of necrolytic acral erythema[J]. Chinese Journal of Dermatology, 2019, 52(9): 604-606.doi:10.3760/cma.j.issn.0412-4030.2019.09.003

参考文献 21

［1］	el Darouti M, Abu el Ela M. Necrolytic acral erythema: a cutaneous marker of viral hepatitis C［J］. Int J Dermatol, 1996,35（4）:252⁃256.
［2］	Abdallah MA, Ghozzi MY, Monib HA, et al. Necrolytic acral erythema: a cutaneous sign of hepatitis C virus infection［J］. J Am Acad Dermatol, 2005,53（2）:247⁃251. doi: 10.1016/j.jaad. 2005.04.049.
［3］	El⁃Ghandour TM, Sakr MA, El⁃Sebai H, et al. Necrolytic acral erythema in Egyptian patients with hepatitis C virus infection［J］. J Gastroenterol Hepatol, 2006,21（7）:1200⁃1206. doi: 10. 1111/j.1440⁃1746.2006.04316.x.
［4］	Das A, Kumar P, Gharami RC. Necrolytic acral erythema in the absence of hepatitis C virus infection［J］. Indian J Dermatol, 2016,61（1）:96⁃99. doi: 10.4103/0019⁃5154.174047.
［5］	Pandit VS, Inamadar AC, Palit A. Seronegative necrolytic acral erythema: a report of two cases and literature review［J］. Indian Dermatol Online J, 2016,7（4）:304⁃307. doi: 10.4103/2229⁃5178. 185464.
［6］	Srisuwanwattana P, Vachiramon V. Necrolytic acral erythema in seronegative hepatitis C［J］. Case Rep Dermatol, 2017,9（1）:69⁃73. doi: 10.1159/000458406.
［7］	Nofal AA, Nofal E, Attwa E, et al. Necrolytic acral erythema: a variant of necrolytic migratory erythema or a distinct entity?［J］. Int J Dermatol, 2005,44（11）:916⁃921. doi: 10.1111/j.1365⁃4632.2004.02232.x.
［8］	Raphael BA, Dorey⁃Stein ZL, Lott J, et al. Low prevalence of necrolytic acral erythema in patients with chronic hepatitis C virus infection［J］. J Am Acad Dermatol, 2012,67（5）:962⁃968. doi: 10.1016/j.jaad.2011.11.963.
［9］	Fielder LM, Harvey VM, Kishor SI. Necrolytic acral erythema: case report and review of the literature［J］. Cutis, 2008,81（4）:355⁃360.
［10］	Zalewski PD, Forbes IJ, Giannakis C. Physiological role for zinc in prevention of apoptosis （gene⁃directed death）［J］. Biochem Int, 1991,24（6）:1093⁃1101.
［11］	Ingenbleek Y, Van Den Schrieck HG, De Nayer P, et al. The role of retinol⁃binding protein in protein⁃calorie malnutrition［J］. Metabolism, 1975,24（5）:633⁃641.
［12］	de Carvalho Fantini B, Matsumoto FY, Arnone M, et al. Necrolytic acral erythema successfully treated with oral zinc［J］. Int J Dermatol, 2008,47（8）:872⁃873. doi: 10.1111/j.1365⁃4632. 2008.03597.x.
［13］	Takagi H, Nagamine T, Abe T, et al. Zinc supplementation enhances the response to interferon therapy in patients with chronic hepatitis C［J］. J Viral Hepat, 2001,8（5）:367⁃371.
［14］	Yost JM, Boyd KP, Patel RR, et al. Necrolytic acral erythema［J］. Dermatol Online J, 2013,19（12）:20709.
［15］	Bentley D, Andea A, Holzer A, et al. Lack of classic histology should not prevent diagnosis of necrolytic acral erythema［J］. J Am Acad Dermatol, 2009,60（3）:504⁃507. doi: 10.1016/j.jaad. 2008.08.046.
［16］	Abdallah MA, Ghozzi MY, Monib HA, et al. Histological study of necrolytic acral erythema［J］. J Ark Med Soc, 2004,100（10）:354⁃355.
［17］	Feldmann R, Wahl S, Steiner A. Normoglycemic glucagonoma syndrome associated with necrolytic migratory erythema［J］. J Eur Acad Dermatol Venereol, 2018,doi: 10.1111/jdv.14852.
［18］	Khanna VJ, Shieh S, Benjamin J, et al. Necrolytic acral erythema associated with hepatitis C: effective treatment with interferon alfa and zinc［J］. Arch Dermatol, 2000,136（6）:755⁃757.
［19］	Hivnor CM, Yan AC, Junkins⁃Hopkins JM, et al. Necrolytic acral erythema: response to combination therapy with interferon and ribavirin［J］. J Am Acad Dermatol, 2004,50（5 Suppl）:S121⁃124. doi: 10.1016/j.jaad.2003.09.017.
［20］	Najarian DJ, Lefkowitz I, Balfour E, et al. Zinc deficiency associated with necrolytic acral erythema［J］. J Am Acad Dermatol, 2006,55（5 Suppl）:S108⁃S110. doi: 10.1016/j.jaad.2005. 09.044.
［21］	Moneib HA, Salem SA, Darwish MM. Evaluation of zinc level in skin of patients with necrolytic acral erythema［J］. Br J Dermatol, 2010,163（3）:476⁃480. doi: 10.1111/j.1365⁃2133.2010. 09820.x.

坏死松解性肢端红斑一例

A case of necrolytic acral erythema

PDF

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献 21

相关文章 0

Metrics

本文评价

推荐阅读 10