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掌跖光泽苔藓:掌跖角化过度的罕见病因

[Palmoplantar lichen nitidus: a rare cause of palmoplantar hyperkeratosis].

作者信息

Thibaudeau A, Maillard H, Croué A, Belperron P, Avenel Audran M, Verret J-L

机构信息

Service de Dermatologie, CHU Angers, 49033 Angers Cedex 01, France.

出版信息

Ann Dermatol Venereol. 2004 Aug-Sep;131(8-9):822-4. doi: 10.1016/s0151-9638(04)93769-6.

Abstract

BACKGROUND

Lichen nitidus is a rare condition, which may be a cause of palmoplantar hyperkeratosis. We report two cases.

CASE REPORTS

A 53 year-old woman presented with a dry and fissured palmoplantar hyperkeratosis. Histological examination of a biopsy showed the typical features of lichen nitidus. Significant improvement was obtained with acitretin. A few months later, multiple lichen nitidus papules appeared on the limbs and the abdomen. A 67 year-old woman was referred to us for a fissured, disabling palmoplantar hyperkeratosis refractory to topical steroids. Histological examination led to the diagnosis of lichen nitidus. Local PUVA therapy resulted in the cleaning of her lesions. Later, typical papules of lichen nitidus appeared on her elbows.

DISCUSSION

Nineteen cases of palmoplantar localization of lichen nitidus have been described. The features are usually tiny yellow papules but sometimes a non-specific keratoderma resembling chronic eczema. Palmoplantar involvement of lichen nitidus may be isolated or associated with cutaneous lesions on unusual sites. Oral retinoids and local PUVA are effective treatments.

摘要

背景

光泽苔藓是一种罕见疾病,可能是掌跖角化过度的病因。我们报告两例病例。

病例报告

一名53岁女性表现为掌跖部干燥、有裂隙的角化过度。活检组织学检查显示有光泽苔藓的典型特征。使用阿维A治疗后有显著改善。几个月后,四肢和腹部出现了多个光泽苔藓丘疹。一名67岁女性因掌跖部有裂隙、致残性角化过度,局部使用类固醇治疗无效而转诊至我院。组织学检查确诊为光泽苔藓。局部光化学疗法使她的皮损消退。后来,她的肘部出现了典型的光泽苔藓丘疹。

讨论

已有19例光泽苔藓掌跖部受累的病例报道。其特征通常为微小的黄色丘疹,但有时是类似慢性湿疹的非特异性角化病。光泽苔藓的掌跖部受累可能是孤立的,也可能与不寻常部位的皮肤损害相关。口服维甲酸类药物和局部光化学疗法是有效的治疗方法。

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