Department of Dermatology, Fukushima Medical University, Fukushima 960-1295, Japan.
Rheumatol Int. 2012 Nov;32(11):3651-3. doi: 10.1007/s00296-010-1513-3. Epub 2010 May 15.
Primary localized cutaneous amyloidosis (PLCA) sometimes shows overlapping with collagen vascular diseases; however, association with Behçet's disease (BD) is rare. We herein report a case of PLCA developing intermingled with papulopustular lesions associated with BD. A 57-year-old woman visited our hospital, complaining of recalcitrant multiple oral aphthae. Further detailed physical examination revealed folliculitis-like small pustules with surrounding erythema on the upper back. Also, she stated past histories of genital ulcers 10 years ago and erythema nodosum on the lower legs 4 years ago. A biopsy specimen from the pustular lesion on the back showed neutrophilic abscess in the epidermis with a number of perivascular inflammatory cells in the upper dermis. Congo-red and Dylon stain revealed amyloid deposition in the papillary dermis. Although association of systemic amyloidosis with BD is occasionally found in the literature, co-occurrence of cutaneous amyloidosis and papulopustular lesions of BD is extremely rare.
原发性皮肤淀粉样变性(PLCA)有时与胶原血管疾病重叠;然而,与贝切特病(BD)的关联很少见。我们在此报告一例与 BD 相关的混合出现丘疹脓疱病变的 PLCA 病例。一名 57 岁女性因顽固多发口腔溃疡就诊。进一步详细的体格检查发现背部有滤泡样小脓疱,周围有红斑。此外,她还表示 10 年前曾有生殖器溃疡病史,4 年前小腿有结节性红斑病史。背部脓疱病变的活检标本显示表皮中性粒细胞脓肿,真皮上层有许多血管周围炎性细胞。刚果红和 Dylon 染色显示在乳头真皮层有淀粉样物质沉积。虽然文献中偶尔会发现系统性淀粉样变性与 BD 有关,但 BD 的皮肤淀粉样变性和丘疹脓疱病变同时发生极为罕见。