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报告1例大疱性疥疮。患者男,65岁。3个月前无明显诱因躯干、四肢出现散在红斑、水疱、糜烂、结痂,伴瘙痒。患者1个月前指缝间、阴囊处出现类似红斑、丘疹,瘙痒明显。皮肤科检查:躯干、四肢可见弥漫性红斑,部分红斑上可见紧张性水疱,疱壁紧张,疱液清亮,部分水疱破裂后糜烂,可见红色糜烂面,部分表面结痂;双手指缝间、阴囊散在红斑,苔藓样变,可见抓痕。皮损组织病理检查:(左股内侧皮损)角化不全,浆液渗出,可见表皮下疱,疱内可见浆液,大量嗜酸性粒细胞及红细胞,真皮浅层可见嗜酸性粒细胞及中性粒细胞浸润;直接免疫荧光:皮肤全层未见特异性荧光,间接免疫荧光:真皮与表皮交界处(-);镜检发现疥螨。诊断:大疱性疥疮。
Report 1 case of bullous scabies. Male patient, 65 years old. 3 months ago no obvious incentive trunk, scattered limbs appear erythema, blisters, erosion, crusting, with itching. Patients 1 month ago finger joints, scrotal erythema, papules, itching obvious. Dermatology examination: trunk, visible diffuse erythema on limbs, some of the erythema can be seen on the blisters, blisters wall blisters blister fluid blisters, some blisters rupture after erosion, showing red erosion surface, some of the surface scab; hands between the scrotum, scrotum Scattered scattered erythema, lichen-like changes, visible scratches. Skin lesions histological examination: (left internal lesion) parakeratosis, serous exudation, visible epidermal blister, blisters visible serous, a large number of eosinophils and erythrocytes, dermis, visible eosinophils and neutral shallow Infiltration of granulocytes; Direct immunofluorescence: No specific fluorescence was observed in the whole layer of skin. Indirect immunofluorescence: junction of dermis and epidermis (-); Scabies mites were found by microscopy. Diagnosis: Bullous scabies.