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患者,女性,21岁。1989年9月因左侧外阴发现斑丘疹伴瘙痒来诊。临床怀疑扁平苔藓进行活检。查体:系统检查无异常。皮肤科情况:左侧大阴唇有1个10mm大小褐色斑疹,境界清楚,周边略高起。大小阴唇及肛门有数10个米粒、黄豆大小丘疹,皮肤表面光亮而坚硬。整个皮损表面干燥及轻度角化。组织病理检查:表皮轻度角化过度,棘层肥厚,皮突延长增宽,表皮细胞排列不整齐,有较多的核大、浓染之细胞及角珠形成,有少许核丝分裂像,真皮毛细血管扩张,周围有慢性炎性细胞浸润。病理诊断:
Patient, female, 21 years old. In September 1989, a diagnosis of macular pimples with pruritus was found in the left vulva. A clinical biopsy of lichen planus is suspected clinically. Physical examination: There is no abnormality in the system check. Dermatology: The left labia majora has a 10mm brown rash with clear boundaries and a slightly elevated circumference. The size of the labia and anus are a few grains of rice and bean-sized papules. The surface of the skin is bright and hard. The entire lesion surface is dry and slightly keratinized. Histopathological examination showed that the epidermis was slightly hyperkeratotic, with acanthosis hypertrophy, proliferative extension of the epidermis, irregular arrangement of epidermal cells, and more nuclear and densely stained cells and keel formation, with a few mitoses. Dermal telangiectasias are surrounded by chronic inflammatory cell infiltration. Pathological diagnosis: