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急性发热性嗜中性皮病1例

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报告1例急性发热性嗜中性皮病.患者女,78岁,因右小腿皮疹伴疼痛1周就诊.皮肤科检查:右小腿屈侧可见一红色水肿性红斑,形态呈大致圆形,面积约14 cm×14 cm,边界欠清,边缘局部分布少量小脓疱,部分脓疱融合、干瘪,局部皮温增高.皮损触之有浸润感,伴有静息痛及压痛.皮损组织病理检查:表皮棘层肥厚,炎症细胞移入,真皮层血管扩张,红细胞外渗,血管周围弥漫的嗜中性粒细胞浸润,间有淋巴细胞、嗜酸性粒细胞,并可见核尘.诊断:急性发热性嗜中性皮病.治疗:予肌肉注射复方倍他米松注射液1 mL,第二天开始晨起顿服曲安西龙片20 mg每日1次.经过9 d的系统糖皮质激素治疗,患者病情好转出院.出院后予口服曲安西龙片16 mg每日1次,门诊随访每周减量4 mg至停药.电话随访1年未复发.目前仍在随访中.
One case of acute febrile neutrophilic dermatosis
We report a case of acute febrile neutrophilic dermatosis.A 78-year-old woman had a one-week history of painful rash on the right lower leg.Dermatological examination revealed a round red,edematous erythema with unclear boundaries,sized 14 cm × 14 cm,on the right poste-rior lower leg.The affected area was warm and tender with a few small pustules,some of which had merged and dried up.Cutaneous infiltration could be felt by palpation.Histopathological changes included thickening of the epidermal spinous layer,inflammatory infiltration,dilation of dermal blood vessels,extravasation of erythrocytes,and diffused perivascular infiltration of neutro-phils,with few lymphocytes,eosinophils,as well as nuclear dust.A diagnosis of acute febrile neutrophilic dermatosis was made.Patient was initially treated with intramuscular injection of 1 mL of compound betamethasone,and oral triamcinolone tablets at a dose of 20 mg/qd was started on the next day.After 9 days of systemic treatment with glucocorticoids,the patient's condition was improved,and the patient was discharged.The patient continued to take oral triamcinolone tablets 16 mg/qd,with a weekly reduction of 4 mg until discontinuation.During a one-year telephone fol-low-up,there was no recurrence.So far,the patient is still under follow-up.

acute febrile neutrophilic dermatosisSweet syndrome

徐凡、魏武杰、郭鑫、贺秋霞、王红梅

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天津市中医药研究院附属医院,天津 300120

急性发热性嗜中性皮病 Sweet综合征

2024

皮肤性病诊疗学杂志
广东省皮肤性病防治中心

皮肤性病诊疗学杂志

影响因子:0.666
ISSN:1674-8468
年,卷(期):2024.31(12)