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目的探讨硬化萎缩性苔藓(LSA)并发局限性硬皮病(LoS)的临床表现、组织病理学特点及诊断,提高对本病的认识,更好地理解硬皮病的疾病谱。方法分析1例LSA并发LoS的临床表现及组织病理特点,复习相关文献并进行讨论。结果患者全身皮损进行性增多无痛痒5年余。2年前初次就诊时明确诊断为LSA,治疗后皮损仍进行性增多,且硬化。此次就诊时皮肤科检查:躯干、四肢散在或密集粟粒至黄豆大瓷白色、略带光泽的扁平丘疹,部分萎缩、硬化;四肢、左手足片状或带状暗红色硬化性斑,部分皮损上有瓷白色扁平丘疹。初次就诊时背部皮损组织病理检查结果显示符合LSA。此次就诊时左小腿皮损组织病理检查结果符合LSA并发硬皮病。结合临床表现和组织病理检查结果,诊断为LSA并发LoS。结论该例LSA并发LoS的患者临床过程、临床表现和组织病理学改变表明,硬皮病可能是谱系性疾病,或许可以认为LSA是浅表性硬皮病。
Objective To investigate the clinical manifestations, histopathological characteristics and diagnosis of sclerosing lichen planus (LSA) complicated with localized scleroderma (LoS), to improve the understanding of this disease and to better understand the disease spectrum of scleroderma. Methods The clinical manifestations and histopathological features of one case of LSA complicated with LoS were analyzed. The related literatures were reviewed and discussed. Results Patients with systemic lesions increased painless itch more than 5 years. Two years ago when the first visit was diagnosed as LSA, after treatment, the lesions are still progressive increase, and sclerosis. Dermatology examination at the time of this visit: trunk, scattered limbs or dense miliary soybeans to large white porcelain, slightly shiny flat papules, partial atrophy, sclerosis; limbs, left foot plate or ribbon dark red sclerosing plaque, part of the skin Damage porcelain white flat pimples. The histological examination of the dorsal lesion at initial visit showed LSA compliance. The left lesion histopathological findings at the time of this visit were consistent with scleroderma with LSA. Combined with clinical manifestations and histopathological findings, diagnosed as LSA complicated by LoS. Conclusions The clinical course, clinical presentation and histopathological changes in patients with LSA complicated with LoS suggest that scleroderma may be a lineage disease and LSA may be considered superficial scleroderma.