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报告1例硬皮病样慢性移植物抗宿主病。患者男,37岁。全身褐色斑块、鳞屑2年,伴溃疡及瘙痒2个月余。患者2011年10月28日于该院行其胞姐HLA6/6相合异基因造血干细胞移植。皮肤科检查:面部、躯干及四肢散在大小不一的褐色斑块,部分融合成大片状,其上可见点片状脱屑,触之稍硬,另散在色素减退斑;双小腿及骶尾部散在大小不一、形状不规则的浅溃疡,基底稍红,表面少许渗液;趾甲及双手拇指指甲变薄萎缩,颜色发白,部分缺失;双侧颊黏膜轻度萎缩及变薄。左小腿皮损组织病理学检查:表皮角化过度,棘层变薄,大片基底细胞液化变性,局部裂隙形成,皮突大部分消失;真皮全层胶原纤维均一化变性,嗜伊红性增强,血管附属器明显减少。根据患者临床及组织病理表现,诊断为硬皮病样慢性移植物抗宿主病。
Report a case of scleroderma-like chronic graft-versus-host disease. Male patient, 37 years old. Whole body brown plaque, scales for 2 years, with ulcers and itching more than 2 months. Patient Oct. 28, 2011 in the hospital line of his sister sister HLA6 / 6 allogeneic hematopoietic stem cell transplantation. Dermatology examination: the face, trunk and limbs scattered in different sizes of brown patches, part of the integration into a large flake, which can be seen flake scaling, the touch of a little hard, and the other dispersed in hypopigmented spots; double leg and sacrococcygeal Scattered in different sizes, the shape of the irregular shallow ulcers, a little red base, the surface a little exudate; toenails and hands thumb nails thinning shrink, white color, partially missing; mild bilateral atrophy and thinning of the buccal mucosa. Left leg skin lesions histopathological examination: epidermal hyperkeratosis, stratum spinosum thinning, large basement cell liquefaction degeneration, local fissures, most of the sudden disappearance of dermis; dermal full-thickness collagen fibers homogenized degeneration, increased eosinophils, Vascular appendages significantly reduced. According to the clinical and histopathological manifestations of patients, the diagnosis of scleroderma-like chronic graft-versus-host disease.