Gerbing Eva Kristina, Metze Dieter, Luger Thomas A, Ständer Sonja
Universitäts-Hautklinik Münster.
J Dtsch Dermatol Ges. 2003 Feb;1(2):137-41.
Interstitial granulomatous dermatitis is a rare entity characterized by cutaneous linear strands (the "rope sign") and rheumatoid arthritis. In the past years, 12 other cases have been described with variable cutaneous symptoms. All showed similar histological features, resembling those of granuloma annulare or 'palisaded neutrophilic and granulomatous dermatitis', suggesting a wide spectrum for a single entity. A 60-year-old patient presented with erythematous patches with an indurated, violaceous border resembling the "rope sign" on both flanks. The histological investigation revealed dense diffuse interstitial inflammatory infiltrates composed of eosinophils, neutrophils, lymphocytes, macrophages and multinucleated giant cells in the superficial and deep dermis. In the deep dermis, prominent eosinophilic degenerated collagen fibres with surrounding macrophages ('floating sign') occurred. In contrast to most previously described patients, our patient did not have arthralgias. The skin findings cleared following therapy with hydroxychloroquine.
间质性肉芽肿性皮炎是一种罕见的疾病，其特征为皮肤出现线状条索（“绳索征”）和类风湿性关节炎。在过去几年中，另外12例病例被描述，其皮肤症状各不相同。所有病例均表现出相似的组织学特征，类似于环状肉芽肿或“栅栏状嗜中性和肉芽肿性皮炎”，提示单一疾病存在广泛的表现谱。一名60岁患者双侧胁腹出现红斑性斑块，边界硬、呈紫罗兰色，类似“绳索征”。组织学检查显示，在真皮浅层和深层有由嗜酸性粒细胞、中性粒细胞、淋巴细胞、巨噬细胞和多核巨细胞组成的密集弥漫性间质炎性浸润。在真皮深层，出现了显著的嗜酸性变性胶原纤维及周围的巨噬细胞（“漂浮征”）。与大多数先前描述的患者不同，我们的患者没有关节痛。经羟氯喹治疗后皮肤症状消退。
