Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon.
Int J Dermatol. 2010 Feb;49(2):184-8. doi: 10.1111/j.1365-4632.2009.04203.x.
Acral pseudolymphomatous angiokeratoma of children (APACHE) is clinically characterized by angiomatous papules that preferentially affect acral areas of children. It is currently believed to be a variant of pseudolymphoma rather than angiokeratoma. Histopathologically, a mixed inflammatory cell infiltrate comprising B- and T-lymphocytes and a proliferation of thick-walled blood vessels are the hallmark. In the literature, although more adult cases are being described, the clinical, epidemiologic and histopathologic data of this presentation is scant. We report a 76-year-old man who presented with a 5-year history of progressively increasing asymptomatic dusky dome-shaped papules and plaques on his upper and lower extremities. Histology was consistent with APACHE. After reviewing all the adult cases in the literature and comparing them to the classical variant in children, we found no significant difference warranting separating these two variants. We prefer the designation "papular angiolymphoid hyperplasia" to APACHE as it encompasses all the childhood and adult cases involving acral and nonacral sites and highlights the histological and sometimes clinical similarities this entity shares with angiolymphoid hyperplasia with eosinophilia.
儿童肢端假性淋巴瘤样血管瘤（APACHE）临床上表现为血管瘤样丘疹，好发于儿童的肢端部位。目前认为它是假性淋巴瘤的一种变体，而不是血管瘤样。组织病理学上，特征是混合性炎症细胞浸润，包括 B 细胞和 T 细胞，以及厚壁血管的增生。在文献中，虽然有越来越多的成人病例被描述，但这种表现的临床、流行病学和组织病理学数据很少。我们报告了 1 例 76 岁男性，其上肢和下肢出现逐渐增大的无症状暗紫色半球形丘疹和斑块，病史 5 年。组织学符合 APACHE。在回顾了文献中的所有成人病例并将其与儿童经典变体进行比较后，我们发现没有明显的差异值得将这两种变体分开。我们更喜欢将“丘疹性血管淋巴样增生”指定为 APACHE，因为它包括所有涉及肢端和非肢端部位的儿童和成人病例，并强调了该实体与伴有嗜酸性粒细胞的血管淋巴样增生在组织学和有时临床方面的相似性。
