Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
J Dermatol. 2011 Apr;38(4):382-5. doi: 10.1111/j.1346-8138.2010.01015.x. Epub 2010 Nov 11.
Interstitial granulomatous dermatitis (IGD) is a reactive phenomenon accompanying disorders including autoimmune disease, lymphoproliferative disorders and drug reactions. Histologically, IGD shows a granulomatous infiltrate surrounding piecemeal fragmentation of collagen in the diffuse interstitium. IGD presents with linear cords, papules and plaques mainly on the trunk and extremities. Herein, we report a case with peculiar clinical features that were histopathologically consistent with IGD. A 74-year-old man presented with periungual painful erythema, nail deformity of all fingers and labial, penile and anal erosive erythema. Histopathological examination of the lesions showed interface dermatitis and a diffuse interstitial granulomatous infiltrate mainly composed of CD68-positive histiocytes and lymphocytes. Degenerative collagen bundles were also observed in granulomas. C-reactive protein and the white blood cell count were elevated, but further examinations did not reveal systemic inflammatory disorders such as autoimmune disease, lymphoproliferative disorder, inflammatory bowel disease or drug hypersensitivity. The lesions were successfully treated with oral and topical steroids.
间质性肉芽肿性皮炎（IGD）是一种伴随自身免疫性疾病、淋巴增生性疾病和药物反应等疾病的反应性现象。组织学上，IGD 表现为弥漫性间质中胶原片段性碎裂周围的肉芽肿浸润。IGD 主要表现为线性索、丘疹和斑块，主要见于躯干和四肢。在此，我们报告一例具有独特临床特征的病例，其组织病理学表现与 IGD 一致。一名 74 岁男性出现甲周疼痛性红斑、所有手指指甲畸形以及唇、阴茎和肛门糜烂性红斑。病变的组织病理学检查显示界面性皮炎和弥漫性间质肉芽肿浸润，主要由 CD68 阳性组织细胞和淋巴细胞组成。肉芽肿中也观察到变性胶原束。C 反应蛋白和白细胞计数升高，但进一步检查未发现自身免疫性疾病、淋巴增生性疾病、炎症性肠病或药物超敏等全身性炎症性疾病。口服和局部类固醇治疗有效。
