Koizumi H, Matsumura T, Kumakiri M, Ohkawara A
Department of Dermatology, Hokkaido University School of Medicine.
Nihon Hifuka Gakkai Zasshi. 1990 Jul;100(8):871-8.
Fifty-six year-old woman had a wide spread nodular and papular eruption on the trunk and arms for one week. She had suffered from primary biliary cirrhosis (PBC) for 8 years. The clinical appearance of the eruption was that of generalized granuloma annulare. Skin biopsy revealed a palisading granuloma in the dermis consisting of suppressor/cytotoxic T cells, Langhans type giant cells, plasmacytoid epithelioid cells and phagocytic macrophages with immunohistochemical analysis and electron microscopy. Liver biopsy showed Scheuer's IIIrd stage of PBC without associated granuloma. In PBC granulomata at the portal area of the liver, lung, muscle, skin and so on has been reported. And the histological findings of the granuloma of this case consisted with that of reported cases. Therefore the skin granuloma in this case was assumed to be related to PBC.
一名56岁女性躯干和手臂出现广泛的结节性和丘疹性皮疹一周。她患原发性胆汁性肝硬化（PBC）已有8年。皮疹的临床表现为全身性环状肉芽肿。皮肤活检显示真皮中有栅栏状肉芽肿，由抑制/细胞毒性T细胞、朗汉斯型巨细胞、浆细胞样上皮样细胞和吞噬性巨噬细胞组成，并进行了免疫组织化学分析和电子显微镜检查。肝脏活检显示为Scheuer PBC III期，无相关肉芽肿。在PBC中，肝脏门区、肺、肌肉、皮肤等部位的肉芽肿已有报道。该病例肉芽肿的组织学表现与报道病例一致。因此，该病例的皮肤肉芽肿被认为与PBC有关。
