中华皮肤科杂志 ›› 2011, Vol. 44 ›› Issue (8): 571-573.

• 论著 • 上一篇    下一篇

丘疹性蕈样肉芽肿一例

王一玲1,刘泽虎2,陈书悦3,郑俊惠3,乔刚4,沈宏4,许爱娥5   

  1. 1. 浙江省杭州市第三人民医院皮肤科
    2. 杭州市第三人民医院
    3.
    4. 杭州市第三人民医院皮肤科
    5. 安徽医科大学附属杭州市第三人民医院皮肤科
  • 收稿日期:2010-10-06 修回日期:2011-02-18 出版日期:2011-08-15 发布日期:2011-07-26
  • 通讯作者: 沈宏 E-mail:shenhangzhou@sina.com

Papular mycosis fungoides: a case report

  • Received:2010-10-06 Revised:2011-02-18 Online:2011-08-15 Published:2011-07-26

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摘要：

患者男，27岁，因左胸部、左腋窝丘疹3年就诊，无自觉症状，皮损持续不退。组织病理检查示棘层轻度增生肥厚，皮突延长，真皮浅层苔藓样淋巴样细胞浸润，部分移入表皮，形成Pautrier微脓肿。免疫组化示LCA（+）、CD45RO（+）、CD3（+）、CD4（+）、CD8散在（+）、CD20（-）、CD68（-），CD30（-）。皮肤激光共聚焦显微镜显示棘层中散在有轻度折光的椭圆或圆形细胞影，直径4 ~ 8 μm。诊断：丘疹性蕈样肉芽肿。治疗：外用丙酸氟替卡松乳膏、异维A酸凝胶，窄波紫外线照射，丘疹变软，色泽变淡。

关键词: 丘疹性

Abstract:

A 27-year-old man presented with a 3-year history of persistent asymptomatic papules on the left chest and axillary fossa. Multiple skin biopsies were performed and histopathology revealed mild acanthosis, extension of the dermal papilla, lichenoid lymphoid infiltrates in upper dermis. Some lymphoid cells migrated into the epidermis and formed Pautrier′s microabscesses. Immunohistochemistry revealed that the infiltrating cells were positive for LCA, CD45RO, CD3, CD4 and CD8 （scattered）, but negative for CD68 or CD30. Cutaneous laser confocal microscopy showed the shadow of scattered, oval or round, slightly refractive cells measuring 4-8 μm in diameter. A diagnosis of papular mycosis fungoides was made. The papules were softened with the lightening of lesional color after treatment with narrow-band ultraviolet B, topical fluticasone propionate cream and isotretinoin gel.

Key words: papular