Kwon Eun J, Hivnor Chad M, Yan Albert C, Forbes Brian, Elenitsas Rosalie, Albert Dan, Pawel Bruce, Honig Paul, Pessler Frank
School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Pediatr Dermatol. 2007 Sep-Oct;24(5):517-24. doi: 10.1111/j.1525-1470.2007.00508.x.
Skin findings in childhood sarcoidosis vary greatly, but only a few occurrences have been published in which the histopathology has been characterized well. We describe a child with sarcoidosis in whom the cutaneous findings were atypical, resembling granuloma annulare. Histologic examination of these cutaneous lesions, however, revealed areas of sarcoid-like epithelioid cell granulomas, a palisading granulomatous process with features of granuloma annulare, as well as palisading neutrophilic and granulomatous dermatitis and interstitial granulomatous dermatitis. This underscores the variability of skin findings in childhood sarcoidosis--even within the same patient--and suggests that sarcoidosis should be considered in the differential diagnosis of children initially diagnosed with granulomatous skin lesions, such as granuloma annulare, palisading neutrophilic, and granulomatous dermatitis or interstitial granulomatous dermatitis, who demonstrate associated signs of systemic disease.
儿童结节病的皮肤表现差异很大,但仅有少数病例报道对其组织病理学特征进行了充分描述。我们报告1例儿童结节病患者,其皮肤表现不典型,类似环状肉芽肿。然而,对这些皮肤损害进行组织学检查发现,存在结节样上皮样细胞肉芽肿区域、具有环状肉芽肿特征的栅栏状肉芽肿过程,以及栅栏状嗜中性粒细胞性和肉芽肿性皮炎和间质性肉芽肿性皮炎。这突出了儿童结节病皮肤表现的变异性,即使在同一患者身上也是如此,并提示对于最初诊断为肉芽肿性皮肤损害(如环状肉芽肿、栅栏状嗜中性粒细胞性和肉芽肿性皮炎或间质性肉芽肿性皮炎)且伴有全身疾病相关体征的儿童,在鉴别诊断时应考虑结节病。