Department of Dermatology, Nishi-Kobe Medical Center, Kobe, Japan.
Dermatology. 2011;223(1):20-4. doi: 10.1159/000330561. Epub 2011 Aug 29.
The patient is a 71-year-old male who has been suffering from rheumatoid arthritis for over 20 years. He first noticed the erythema on his right forearm in 2008, which got worse in 2009. Topical corticosteroids were not effective, and a skin biopsy was performed. Histopathologic examination showed aggregation of the inflammatory cells in the dermal vessels. Those cells were positive for CD68 and CD31 and all the surrounding vessels expressed D2-40 and CD31. We diagnosed him with intralymphatic histiocytosis. One week after the skin was biopsied, only the part of the erythematous lesion covered by skin tape had improved, suggesting that pressure on the lesion might improve the erythematous eruption. We therefore used a pressure bandage elbow supporter in addition to topical treatment. The lesion improved 3 months later and was totally diminished after 9 months. Combined with previously reported cases, our case suggested that intralymphatic histiocytosis is closely related to lymphostasis.
患者为 71 岁男性，患有类风湿关节炎 20 余年。2008 年首次发现右侧前臂红斑，2009 年加重。外用糖皮质激素无效，行皮肤活检。组织病理检查显示真皮血管内炎症细胞聚集。这些细胞 CD68 和 CD31 阳性，所有周围血管均表达 D2-40 和 CD31。诊断为淋巴管内组织细胞增生症。皮肤活检后 1 周，仅用皮肤胶带覆盖红斑部位改善，提示病变处受压可能改善红斑发作。因此，除了局部治疗外，我们还使用了压力绷带肘支撑器。3 个月后皮损改善，9 个月后完全消退。结合以往报道的病例，我们的病例提示淋巴管内组织细胞增生症与淋巴淤滞密切相关。
