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自限性幼年皮肤黏液瘤病:9 例患者的临床和组织病理学发现:长期随访的相关性。

Self-healing juvenile cutaneous mucinosis: Clinical and histopathologic findings of 9 patients: The relevance of long-term follow-up.

机构信息

Department of Dermatology, Centre National de Référence des Maladies Génétiques à Expression Cutanée (MAGEC), Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.

Department of Dermatology, Centre National de Référence des Maladies Génétiques à Expression Cutanée (MAGEC), Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France; Department of Dermatology, Centre Hospitalier Universitaire Ste-Justine, Montréal, Quebec, Canada.

出版信息

J Am Acad Dermatol. 2018 Jun;78(6):1164-1170. doi: 10.1016/j.jaad.2017.10.023. Epub 2017 Oct 21.

Abstract

BACKGROUND

Self-healing juvenile cutaneous mucinosis (SHJCM) is a rare disorder, and its pathogenesis and long-term prognosis are unknown.

OBJECTIVE

To elucidate the clinical and histopathologic characteristics, pathogenesis, and outcome in patients with SHJCM.

METHODS

Retrospective study of 9 patients with SHCJM. To complement initial findings, data collection forms were sent to the referring physicians.

RESULTS

All patients had an acute onset of firm nodules. Of the 9 patients, 6 presented initially with waxy papules on the dorsum of the hands; 5 suffered from periorbital edema, and 6 had a febrile prodrome. Histopathologic assessment of the papules revealed dermal mucin deposition, whereas the nodules showed proliferative fasciitis-like features or nonspecific chronic lobular panniculitis. Laboratory studies elicited evidence of active viral infection in 2 patients (human herpes virus 6 and rotavirus). Seven cases had spontaneous resolution within 6 months, and 2 patients with incomplete resolution showed subsequent transition to fibroblastic rheumatism and an autoinflammatory rheumatologic disease, respectively.

LIMITATIONS

This was a retrospective study with incomplete data from referring physicians.

CONCLUSIONS

Although spontaneous complete regression is expected, patients with SHJCM need long-term follow-up because of the possible development of dematorheumatolgic conditions. The pathogenetic role of microbial agents deserves further investigation.

摘要

背景

自限性幼年皮肤黏液瘤病(SHJCM)是一种罕见的疾病,其发病机制和长期预后尚不清楚。

目的

阐明 SHJCM 患者的临床和组织病理学特征、发病机制和转归。

方法

对 9 例 SHCJM 患者进行回顾性研究。为了补充初步发现,向转诊医生发送了数据收集表。

结果

所有患者均急性发作硬结性结节。9 例患者中,6 例最初在手背部出现蜡样丘疹;5 例有眶周水肿,6 例有发热前驱期。丘疹的组织病理学评估显示真皮黏液沉积,而结节显示增生性筋膜炎样特征或非特异性慢性小叶性脂肪炎。2 例患者(人疱疹病毒 6 型和轮状病毒)的实验室研究提示存在活动性病毒感染。7 例在 6 个月内自发消退,2 例未完全消退的患者分别随后发展为纤维母细胞瘤性风湿病和自身炎症性风湿病。

局限性

这是一项回顾性研究,转诊医生提供的数据不完整。

结论

尽管预计会自发完全缓解,但由于可能发生自身免疫性疾病,SHJCM 患者需要长期随访。微生物制剂的发病机制作用值得进一步研究。

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