Nakajima H, Ikeda M, Yamamoto Y, Kodama H
Department of Dermatology, Kochi Medical School, Japan.
J Dermatol. 1999 Jul;26(7):452-6. doi: 10.1111/j.1346-8138.1999.tb02025.x.
A 53-year-old female developed erythema elevatum diutinum (EED) twelve years after the onset of rheumatoid arthritis. The arthritis had been well controlled for the last several years. Annular purpuric macules were characteristically complicated by common nodular and plaque lesions. Both leukocytoclastic vasculitis and fibrosis were observed in the macular lesions, indicating that the lesions were a manifestation of an early phase of EED. Both types of skin lesions disappeared with treatment with dapsone. They have not relapsed for two years after stopping the dapsone. The leukocytoclastic vasculitis was thought to have developed independently of the rheumatoid arthritis. She had noticed sicca symptoms two years before the appearance of EED, but she did not satisfy the diagnostic criteria for Sjögren's syndrome.
一名53岁女性在类风湿关节炎发病12年后出现持久性隆起性红斑（EED）。在过去几年中，关节炎病情一直得到良好控制。特征性的环形紫癜性斑疹常伴有常见的结节和斑块病变。在斑疹病变中观察到白细胞破碎性血管炎和纤维化，表明这些病变是EED早期阶段的表现。两种类型的皮肤病变经氨苯砜治疗后均消失。停用氨苯砜后两年未复发。白细胞破碎性血管炎被认为是独立于类风湿关节炎发生的。在EED出现前两年她就已注意到干燥症状，但她不符合干燥综合征的诊断标准。
