Missall Tricia A, Pruden Samuel, Nelson Christine, Fohn Laurel, Vidal Claudia I, Hurley M Yadira
Department of Dermatology, School of Medicine, Saint Louis University, St Louis, MO 63104, USA.
Am J Dermatopathol. 2012 Jun;34(4):446-8. doi: 10.1097/DAD.0b013e318231ae4a.
A 23-year-old Chinese man presented with a 3-year history of a pruritic eruption. On examination, pink urticarial papules associated with hyperpigmented reticulated patches were noted on his neck, back, and upper chest. Histopathology revealed vacuolar interface dermatitis and numerous gram-negative rods within a dilated hair follicle. The organisms were reactive with anti-Helicobacter pylori immunohistochemisty. The histologic findings and clinical presentation support the diagnosis of prurigo pigmentosa. Additional testing demonstrated a positive urease breath test and serum H. pylori IgG antibodies. The patient was referred to gastroenterology and treated with appropriate antibiotics. After treatment, esophagogastroduodenoscopy revealed chronic gastritis without evidence of H. pylori infection and his skin showed reticulated hyperpigmented patches without evidence of active inflammatory papules. Although previous reports have associated prurigo pigmentosa to H. Pylori gastritis, this is the first report of H. pylori organisms identified in a skin biopsy of prurigo pigmentosa.
一名23岁的中国男性，有3年瘙痒性皮疹病史。检查发现其颈部、背部和上胸部有粉红色风团样丘疹，伴有色素沉着的网状斑。组织病理学显示空泡状界面性皮炎，扩张的毛囊内有大量革兰氏阴性杆菌。这些微生物对抗幽门螺杆菌免疫组化呈阳性反应。组织学表现和临床表现支持色素性痒疹的诊断。进一步检查显示尿素呼气试验阳性和血清幽门螺杆菌IgG抗体阳性。该患者被转诊至胃肠病科，并接受了适当的抗生素治疗。治疗后，食管胃十二指肠镜检查显示为慢性胃炎，无幽门螺杆菌感染证据，其皮肤显示网状色素沉着斑，无活动性炎性丘疹。尽管先前的报道将色素性痒疹与幽门螺杆菌胃炎相关联，但这是首次在色素性痒疹的皮肤活检中鉴定出幽门螺杆菌。
