Gonzalez Santiago Tania M, Wetter David A, Lowe Garrett C, Sciallis Gabriel F
Department of Dermatology, Mayo Clinic, Rochester, MN.
Department of Dermatology, Mayo Clinic, Rochester, MN;
Skinmed. 2017 Jun 1;15(3):218-220. eCollection 2017.
A 46-year-old woman with a 30 pack-year smoking history presented with a worsening eruption on the left cheek that failed to improve with metronidazole gel. The cutaneous eruption spread to most of her face and did not respond to a brief tapering course of prednisone. During the initial evaluation at our institution, approximately 6 weeks after the onset of the cutaneous eruption, the patient had erythematous, crusted plaques on her face and scalp (Figure 1A); they were also present on the V-area of the anterior aspect of the neck and upper region of the chest, the shoulders, and the arms, with isolated lesions on the trunk and legs. Her oral mucosa had erythematous erosions on the hard palate and gingivae. A review of systems revealed pain and burning of her skin lesions, but no muscle weakness or other systemic clinical manifestations. The differential diagnosis included autoimmune connective tissue disease, pemphigus foliaceous, sarcoidosis, lichen planus, phototoxic drug eruption, and eczema herpeticum.
一名有30年吸烟史、46岁的女性，左脸颊皮疹加重，使用甲硝唑凝胶治疗无效。皮疹蔓延至她大部分面部，短期逐渐减量使用泼尼松也无反应。在我院进行初始评估时，皮疹出现约6周后，患者面部和头皮有红斑、结痂斑块（图1A）；颈部前方V区、胸部上部、肩部和手臂也有，躯干和腿部有孤立性皮损。她的口腔黏膜在硬腭和牙龈处有红斑糜烂。系统回顾显示皮肤损害有疼痛和烧灼感，但无肌无力或其他全身临床表现。鉴别诊断包括自身免疫性结缔组织病、落叶型天疱疮、结节病、扁平苔藓、光毒性药物疹和疱疹样湿疹。
