Taketuchi Y, Chinen T, Ichikawa Y, Ito M
First Department of Dermatology, Toho University School of Medicine, Tokyo, Japan.
J Dermatol. 2001 Sep;28(9):493-8. doi: 10.1111/j.1346-8138.2001.tb00018.x.
Two cases of pigmented purpuric dermatosis showing unusual distribution are reported. Case 1: 35-year-old female. A group of three asymptomatic purpuric macules developed on the ulnar side of the elbow flexure of the left forear 3-6 months before presentation. Histopathological analysis revealed a band-like inflammatory infiltrate in the Uppermost dermis and extravasation of red blood cells just beneath the epidermis, but there was no evidence of lichefaction degeneration in the basal layer of the epidermis. Case 2: 26-year-old female. Asymptomatic purpuric pigmentations developed on the flexure side of the right lower extremity in a linear arrangement 2-3 months before presentation. Histopathological analysis revealed focally perivascular inflammatatory infiltrates consisting mainly of lymphocytes and conspicuous extravasation of red blood cells into the papillary dermis. There was no histological evidence of vasculitis in either case. Hemosiderin deposits were more limited than expected in both patients. Both cases are compatible with diagnoses of pigmented purpuric dermatosis. Case 1 on the left arm was compatible with lichen purpuricus. Case 2 occurred in a linear arrangement on the right leg and had a history of aspirin use for chronic headache. We therefore suspected that medication had been an etiological or contributing factor.
报告了两例色素性紫癜性皮病表现出异常分布的病例。病例1：35岁女性。在就诊前3 - 6个月，左前臂肘前屈侧尺侧出现一组三个无症状的紫癜性斑疹。组织病理学分析显示，最上层真皮有带状炎性浸润，表皮下有红细胞外渗，但表皮基底层无苔藓样变性证据。病例2：26岁女性。在就诊前2 - 3个月，右下肢屈侧出现呈线性排列的无症状紫癜性色素沉着。组织病理学分析显示，血管周围有局灶性炎性浸润，主要由淋巴细胞组成，且有明显的红细胞外渗至乳头层真皮。两例均无血管炎的组织学证据。两例患者的含铁血黄素沉积均比预期的更局限。两例均符合色素性紫癜性皮病的诊断。左臂的病例1符合紫癜性苔藓。病例2发生在右腿，呈线性排列，有因慢性头痛服用阿司匹林的病史。因此，我们怀疑药物是病因或促成因素。
