中华皮肤科杂志 ›› 2008, Vol. 41 ›› Issue (10): 650-652.

• 论著 • 上一篇    下一篇

Blau综合征一例

陈宏 常晓萍   

  1. 天津市长征医院皮肤科
  • 收稿日期:2007-11-01 修回日期:2008-05-07 发布日期:2008-10-15
  • 通讯作者: 陈宏 E-mail:baixue20042006@126.com

Blau syndrome: a case report and review of literature

  

  • Received:2007-11-01 Revised:2008-05-07 Published:2008-10-15

摘要: 患儿女,4岁,全身皮肤弥漫性丘疹、红斑、脱屑,大关节处皮下结节伴进行性眼损害3年。患儿出生后3个月出现下肢丘疹,逐渐累及全身。一次高热后出现眼部病变,诊断为双角膜白斑,陈旧性虹膜炎,虹膜后粘连。体检:双角膜散在灰白色混浊,边界清,前房浅,虹膜斑不清,瞳孔不圆,有后粘连。全身浅表淋巴结不大。皮肤科检查:全身弥漫性丘疹、红斑、脱屑、表面粗糙,似鱼鳞病,皮肤皱纹增多,皮温较高,无汗。腕、踝、膝关节部位大小不等的包块,质软,可活动。无红肿疼痛等症状。双眼B超显示双玻璃体混浊,双玻璃体后脱离,玻璃体后界膜下渗出,眼压降低。背部、腰部及手背部皮损及腕部皮下结节活检示:表皮棘层增厚,真皮内可见大量组织细胞、泡沫细胞及多核巨细胞浸润。其余检查无明显异常。诊断:Blau 综合征。此病为常染色体显性遗传性疾病,目前无有效的治疗方法。

关键词: blau 综合征, 病理学

Abstract: A 4-year-old girl presented with generalized papules, erythema, desquamation, subcutaneous nodules around large joints, as well as a 3-year-history of progressive eye damage. Three months after her birth, papules developed on the lower limbs, and gradually spread to involve the whole body. Eye damage appeared after a high fever and she was diagnosed with keratoleukoma, old iritis, and posterior synechia. Physical examination revealed sharply demarcated corneal opacity, shallow anterior chamber, obscure irides, and posterior synechia; pupils were not round. No superficial lymphadenectasis was observed. Dermatological examination showed ichthyosis-like coarse skin with generalized papules, erythema and desquamation, increased wrinkles and absence of sweat. Skin temperature was higher than normal. There were soft, irregularly sized, non-tender, movable subcutaneous masses at the wrist, ankle and knee joints without inflammation or warmth. Type-B ultrasonography of both eyes disclosed vitreous opacification, posterior detachment of vitreous, extravasation at the posterior vitreous membrane, and decreased intraocular pressure. Histopathology of lesions on the back, waist, and back of hands as well as subcutaneous nodules on the wrists showed epidermal acanthosis and infiltration with a large number of histiocytes, foam cells and multinucleated giant cells in the dermis. No abnormal findings were observed from other examinations. This case was diagnosed as Blau syndrome, which is an autosomal dominant inherited disease; currently, there is no effective therapy for it.

Key words: blau syndrome, pathology