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患者女,51岁,四肢肿胀并硬化4个月,加重10d。4个月前患者劳累后出现双下肢肿胀并硬化,伴疼痛,10d前呈橘皮样外观,双上肢屈侧对称性条沟状凹陷,瘙痒和疼痛明显,无溃烂及渗液,外周血嗜酸性粒细胞明显增多。22MHz高频超声示:表皮回声正常,真皮回声稍低,部分扩大,肌肉筋膜层明显低回声并加宽。皮损组织病理示:皮下纤维脂肪组织中见较多嗜酸性粒细胞、淋巴细胞及浆细胞浸润,皮下脂肪及浅筋膜见轻度纤维化及黏液样变性。诊断:嗜酸性筋膜炎。予甲泼尼龙和五味消毒饮治疗3周后,血EOS正常,22MHz高频超声示:真皮深层的低回声带消失,肌肉筋膜层恢复正常。
Female, 51 years old, swollen and hardened limbs for 4 months, increased 10d. 4 months ago, the patient experienced exertion after swelling and sclerosis of both lower extremities, with pain, orange peel-like appearance before 10d, bilateral upper extremity flexion symmetry stripe-shaped depression, itching and pain, no ulceration and exudate, peripheral blood addicts Acidic granulocytes significantly increased. 22MHz high-frequency ultrasound showed: epidermis echo normal dermal echo slightly lower, part of the expansion, muscle fascia significantly lower echo and widened. Histopathology showed: subcutaneous fibrous adipose tissue to see more eosinophils, lymphocytes and plasma cells infiltration, subcutaneous fat and superficial fascia seen mild fibrosis and myxoid degeneration. Diagnosis: Acidophilic fasciitis. After 3 weeks of treatment with methylprednisolone and Wuwei Disinfectant, blood EOS was normal and high frequency ultrasound at 22 MHz showed that the deep hypoechoic zone of the dermis disappeared and the muscle fascia returned to normal.