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患者女,60岁。躯干及四肢散在分布红斑并伴有鳞屑2年余。3个月前当地医院以“银屑病”予窄谱中波紫外线照射治疗,治疗2次后诉皮疹明显增多,手指轻度肿胀并冰凉。右上臂皮损组织病理示:角化过度伴角化不全,角栓形成,表皮萎缩变薄,基底细胞液化变性,真皮乳头水肿,真皮内深浅血管周围可见灶状淋巴细胞浸润;免疫学示:ANA(+):1∶1 000,SSA抗体(+),SSB抗体(-),ds-DNA抗体(-)。诊断:丘疹鳞屑型亚急性皮肤型红斑狼疮。考虑窄谱中波紫外线照射治疗为导致病情加重的重要因素。
Female patient, 60 years old. Scattered distribution of the trunk and extremities with erythema and scaly more than 2 years. 3 months ago, the local hospital to “psoriasis ” to narrow spectrum UVB treatment, after treatment 2 times rash was significantly increased, slightly swollen fingers and cold. Right upper arm lesions showed histopathology: hyperkeratosis with parakeratosis, corner formation, thinning of the epidermis, basal cell liquefaction, dermal papillary edema, deep within the dermis visible focal lymphoid infiltration; Immunology showed: ANA (+): 1: 1,000, SSA antibody (+), SSB antibody (-), ds-DNA antibody (-). Diagnosis: papular squamous subacute cutaneous lupus erythematosus. Considering the treatment of narrow-band UVB radiation is an important factor leading to aggravating conditions.