PDF(Pubmed)
Abstract：
UNASSIGNED: Actinic granuloma (AG) is a rare skin eruption thought to result from a sun-induced inflammatory response attracting giant cells, which are large, multinucleated, and inflammatory, to form granulomas and degrade surrounding elastic material. Clinically, lesions begin on sun-exposed skin as pink papules and nodules that coalesce into demarcated annular plaques with a hypopigmented center. Histologically, actinic elastosis surrounds the outer annulus ring, with histiocytes and giant cells within the raised border, and the innermost central zone is filled with minimal to absent elastic fibers.
UNASSIGNED: We present a middle-aged female with a pruritic eruption of diffuse erythematous macules and papules coalescing into plaques with mild scale involving the scalp, face, neck, torso, and upper and lower extremities, including the palms and soles, but sparing the ears, bilateral axillae, elbows, and knees. Skin biopsies revealed solar elastosis and abundant multinucleated foreign body giant cells with ingested elastic fibers. The patient\'s clinical presentation and histopathology were consistent with a diagnosis of AG. Furthermore, spirochete immunostaining of the specimens revealed multiple Treponema pallidum spirochetes throughout the epidermis and dermis. Secondary syphilis with primary chancre was added to the diagnosis. Treatment included oral and topical steroids followed by intravenous penicillin G. After 1 month, all lesions had resolved with post-inflammatory erythema.
UNASSIGNED: Our patient differs from the typical presentation in describing intense pruritus with her eruption. This interesting collision reminds clinicians to retain a high index of suspicion for multiple diagnoses in a single patient.
UNASSIGNED: We present a middle-aged female with a pruritic eruption of diffuse erythematous macules and papules coalescing into plaques with mild scale involving the scalp, face, neck, torso, and upper and lower extremities, including the palms and soles, but sparing the ears, bilateral axillae, elbows, and knees. Skin biopsies revealed solar elastosis and abundant multinucleated foreign body giant cells with ingested elastic fibers. The patient\'s clinical presentation and histopathology were consistent with a diagnosis of AG. Furthermore, spirochete immunostaining of the specimens revealed multiple Treponema pallidum spirochetes throughout the epidermis and dermis. Secondary syphilis with primary chancre was added to the diagnosis. Treatment included oral and topical steroids followed by intravenous penicillin G. After 1 month, all lesions had resolved with post-inflammatory erythema.
UNASSIGNED: Our patient differs from the typical presentation in describing intense pruritus with her eruption. This interesting collision reminds clinicians to retain a high index of suspicion for multiple diagnoses in a single patient.
摘要：
■光化性肉芽肿（AG）是一种罕见的皮肤喷发，被认为是由阳光诱导的吸引巨细胞的炎症反应引起的，它们很大，多核化，和炎症，形成肉芽肿并降解周围的弹性材料。临床上,病变始于暴露于阳光下的皮肤，表现为粉红色丘疹和结节，并合并成具有色素沉着中心的标定环形斑块。组织学上,光化性弹性增生围绕着外环环，组织细胞和巨细胞在凸起的边界内，并且最内部的中心区域填充有最少至不存在的弹性纤维。
■我们介绍了一位中年女性，她出现了瘙痒性的弥漫性红斑和丘疹，合并成斑块，头皮有轻度鳞屑，脸,脖子,躯干,上肢和下肢，包括手掌和脚底,但保留耳朵，双侧腋窝，肘部,和膝盖。皮肤活检显示日光弹性沉着症和大量的多核异物巨细胞，并摄入了弹性纤维。患者的临床表现和组织病理学与AG的诊断一致。此外，标本的螺旋体免疫染色显示表皮和真皮中有多个梅毒螺旋体。诊断中增加了带有原发性下颌的继发性梅毒。治疗包括口服和局部类固醇，然后静脉注射青霉素G。1个月后，所有病变均出现炎症后红斑.
■我们的患者与典型的表现不同，在描述她的爆发时剧烈瘙痒。这种有趣的碰撞提醒临床医生对单个患者的多种诊断保持高度怀疑。
■我们介绍了一位中年女性，她出现了瘙痒性的弥漫性红斑和丘疹，合并成斑块，头皮有轻度鳞屑，脸,脖子,躯干,上肢和下肢，包括手掌和脚底,但保留耳朵，双侧腋窝，肘部,和膝盖。皮肤活检显示日光弹性沉着症和大量的多核异物巨细胞，并摄入了弹性纤维。患者的临床表现和组织病理学与AG的诊断一致。此外，标本的螺旋体免疫染色显示表皮和真皮中有多个梅毒螺旋体。诊断中增加了带有原发性下颌的继发性梅毒。治疗包括口服和局部类固醇，然后静脉注射青霉素G。1个月后，所有病变均出现炎症后红斑.
■我们的患者与典型的表现不同，在描述她的爆发时剧烈瘙痒。这种有趣的碰撞提醒临床医生对单个患者的多种诊断保持高度怀疑。
