Hibler Brian P, Eastman Kristin L, Bennett Daniel D, Swanson Andrew M, Longley B Jack, Wood Gary S
Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI;
Skinmed. 2016 Apr 1;14(2):153-5. eCollection 2016.
A 50-year-old woman presented to our clinic for evaluation of numerous recurrent, pruritic papules on her upper extremities. She reported a 2- to 3-year history of up to eight unique lesions on the bilateral upper arms that would initially appear as firm papules before gradually softening and flattening out, leaving residual pink macules (Figure 1A). Her medical history was notable for mild hyperlipidemia. On presentation, she had several erythematous papules with overlying telangiectasias scattered throughout her bilateral upper arms. One lesion of concern over the left deltoid had been present for 5 months without signs of regression (Figure 1B). Pathology of this and a similar lesion showed histiocytes forming Touton giant cells with foamy cytoplasm consistent with a xanthogranuloma (AXG). Results from immunoperoxidase stains were negative for factor XIIIa and CD1a, diffusely positive for CD68, and focally positive for S100 (Figure 2).
一名50岁女性前来我们诊所，评估其上肢出现的大量复发性瘙痒性丘疹。她报告称，双侧上臂出现多达8个独特皮损已有2至3年病史，这些皮损最初表现为坚实的丘疹，随后逐渐变软、变平，留下残留的粉红色斑疹（图1A）。她有轻度高脂血症病史。就诊时，她双侧上臂散在分布着几个伴有毛细血管扩张的红斑丘疹。左三角肌处一个令人担忧的皮损已存在5个月，且无消退迹象（图1B）。对这个皮损及一个类似皮损进行病理检查，结果显示组织细胞形成了具有泡沫状细胞质的图顿巨细胞，符合黄瘤病（AXG）。免疫过氧化物酶染色结果显示，XIIIa因子和CD1a呈阴性，CD68弥漫性阳性，S100局灶性阳性（图2）。
