Chang S N, Kim S C, Chun Y S, Kim K T, Ahn S K, Park W H
Department of Dermatology, College of Medicine Pochon CHA University, Korea.
J Dermatol. 1999 Jul;26(7):442-7. doi: 10.1111/j.1346-8138.1999.tb02023.x.
Chronic recurrent pruritic papular eruptions in which a specific diagnosis cannot be established becomes a baffling experience to the dermatologist. We have met adult male patients with chronic recurrent pruritic papular eruptions, but their clinicopathological features are not described in English language textbooks. Our purpose was to study the clinical and histological features of this entity and review the various existing taxonomy. We conducted a study of 20 patients over a six year period by taking histories, performing skin biopsies, screening patch tests, and doing immunofluoresence studies. The eruptions occurred exclusively in male adults and had a predilection for the trunk and proximal extremities. The lesions were characterized by severely pruritic, nonfollicular, monomorphic, erythematous urticarial papules. There was no evidence of atopic diathesis or history of insect bite. Most patients had normal levels of serum eosinophils and IgE. The predominant histopathologic finding was a presence of perivascular infiltration of mononuclear cells with eosinophils. The patients followed a chronic course of at least six months with waxing and waning; systemic corticosteroids were the only effective treatment. Finally, all other pruritic erythematous papular dermatoses were ruled out. These cases comprise a distinct entity that has previously been mentioned in a few reports. Clear definition of this entity with an appropriate designation is in order to avoid confusion among dermatologists, and we propose the disease name "chronic papular dermatitis in adult men" as a variant of prurigo.
对于皮肤科医生来说，无法做出明确诊断的慢性复发性瘙痒性丘疹性皮疹是一件令人困惑的事情。我们遇到过患有慢性复发性瘙痒性丘疹性皮疹的成年男性患者，但英文教科书并未描述其临床病理特征。我们的目的是研究该疾病的临床和组织学特征，并回顾现有的各种分类法。我们在六年时间里对20名患者进行了研究，包括采集病史、进行皮肤活检、筛查斑贴试验以及进行免疫荧光研究。皮疹仅发生于成年男性，好发于躯干和四肢近端。皮损的特点为严重瘙痒、非毛囊性、单形性、红斑性风团样丘疹。没有特应性素质或昆虫叮咬史的证据。大多数患者血清嗜酸性粒细胞和IgE水平正常。主要的组织病理学表现为单核细胞伴嗜酸性粒细胞的血管周围浸润。患者病程至少持续六个月，病情有波动；全身用皮质类固醇是唯一有效的治疗方法。最后，排除了所有其他瘙痒性红斑性丘疹性皮肤病。这些病例构成了一个独特的疾病实体，此前已有少数报告提及。为避免皮肤科医生之间的混淆，应对该实体进行明确界定并给予恰当命名，我们建议将该疾病命名为“成年男性慢性丘疹性皮炎”，作为痒疹的一种变体。
