Battle L R, Shalin S C, Gao L
Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Clin Exp Dermatol. 2015 Jun;40(4):387-90. doi: 10.1111/ced.12549. Epub 2014 Dec 18.
The granulomatous variant of the pigmented purpuric dermatoses (PPDs) is a rare and infrequently described condition, with a total of 16 cases published to date. We report a case of granulomatous PPD in a 59-year-old white woman who demonstrated involvement of the arms, legs, chest and back with concurrent hyperlipidaemia. Histopathological examination revealed a lymphohistiocytic infiltrate obscuring the dermoepidermal junction, and loose granuloma formation in the superficial dermis, with extravasated erythrocytes. Other conditions within the differential diagnosis such as atypical infection, papular sarcoidosis and generalized granuloma annulare were excluded on clinical and histological grounds. Our patient represents the ninth patient reported to have granulomatous PPD with coexisting hyperlipidaemia, and the fifth patient with granulomatous PPD and a lichenoid infiltrate.
色素性紫癜性皮病（PPDs）的肉芽肿变体是一种罕见且鲜有描述的病症，迄今为止共发表了16例病例报告。我们报告了一例59岁白人女性的肉芽肿性PPD病例，该患者的手臂、腿部、胸部和背部均有病变，同时伴有高脂血症。组织病理学检查显示，淋巴细胞和组织细胞浸润模糊了真皮表皮交界处，浅层真皮内形成松散的肉芽肿，并伴有红细胞外渗。基于临床和组织学依据，排除了鉴别诊断中的其他病症，如非典型感染、丘疹性结节病和泛发性环状肉芽肿。我们的患者是第九例报告患有肉芽肿性PPD并伴有高脂血症的患者，也是第五例患有肉芽肿性PPD并伴有苔藓样浸润的患者。
