Tokuda Y, Kawachi S, Murata H, Saida T
Division of Dermatology, Matsumoto National Hospital, 1209 Yoshikawa Murai-cho, Matsumoto, Nagano 399-8701, Japan.
Br J Dermatol. 2006 Jan;154(1):157-61. doi: 10.1111/j.1365-2133.2005.06901.x.
Pretibial mucin deposition on the shins is known as pretibial myxoedema. We report three patients with pretibial mucinosis without thyroid disease. The patients were characterized clinically by morbid obesity and bilateral lower extremity pitting oedema with gradual and painless onset, and that did not involve the feet and ankles. Vesicles, semitranslucent papules or a woody plaque were found on the shins. Histologically, patients showed characteristic features of epidermal atrophy with effacement of the rete ridge pattern, separation of collagen bundles associated with oedema with stellate to linear fibroblasts, upward-running increased capillary and small vessels with haemosiderin deposition, and mucin deposition at the superficial papillary dermis and around the vessels. We propose that the present cases of 'chronic obesity lymphoedematous mucinosis' belong to the clinical entity of pretibial mucinosis.
胫前粘蛋白沉积于小腿胫前部被称为胫前黏液性水肿。我们报告了3例无甲状腺疾病的胫前黏液沉着病患者。这些患者的临床特征为病态肥胖和双侧下肢凹陷性水肿，起病缓慢且无痛，不累及足部和踝部。在小腿胫前部发现水疱、半透明丘疹或木样斑块。组织学上，患者表现出特征性改变，包括表皮萎缩、 rete嵴模式消失、胶原束分离伴水肿及星状至线性排列的成纤维细胞、向上走行的毛细血管和小血管增多伴含铁血黄素沉积，以及浅表乳头真皮层和血管周围的粘蛋白沉积。我们认为目前这些“慢性肥胖性淋巴水肿性粘蛋白沉着病”病例属于胫前黏液沉着病的临床实体。
