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黄色瘤样肥大细胞增多症:一种罕见的皮肤肥大细胞增多症形式

[Xanthelasmoid mastocytosis: a rare form of cutaneous mastocytosis].

作者信息

Ramid Hind, Hali Fouzia

机构信息

Service de Dermatologie et de Vénérologie du CHU Ibn Rochd, Casablanca, Maroc.

出版信息

Pan Afr Med J. 2017 Oct 4;28:104. doi: 10.11604/pamj.2017.28.104.13629. eCollection 2017.

Abstract

Mastocytosis is a rare disease characterized by the abnormal accumulation of mast cells in the skin and possibly in other organs. It can occur in a variety of forms; xanthelasmoid mastocytosis(XM) is a very rare form classified as papulo-nodular. Clinically, it appears as buff-yellow soft papules or nodules of variable size. Triggerings are those of classic mastocytosis. Darier's sign is often absent. Histology shows dense infiltrate of mast cells in the deep dermis. This clinical form can be singled out because of the persistence of lesions beyond puberty without the additional risk of systemic involvement. We here report the case of a 18-month old female infant, with no previous medical history. Maculopapular, intensely pruritic, ovalaires, brownish lesions with a buff-yellow centre, with elastic consistency and different sizes first occurred at the age of 8 months. The initial interview of parents revealed that the infant had had episode of flush especially caused by warmth. Darrier's sign was negative. Skin biopsy showed dermal infiltrate of mast cells, allowing to retain the diagnosis of xanthelasmoid mastocytosis. Complementary examinations as well as trypsin dosage were normal. Treatment was based on the exclusion of drugs and of factors participating in mast cells degranulation and antihistamines.

摘要

肥大细胞增多症是一种罕见疾病,其特征为肥大细胞在皮肤以及可能在其他器官中异常积聚。它可以有多种形式;睑黄瘤样肥大细胞增多症(XM)是一种非常罕见的形式,归类为丘疹结节型。临床上,它表现为大小不一的浅黄色柔软丘疹或结节。诱发因素与经典肥大细胞增多症相同。通常无达里埃氏征。组织学显示真皮深层有密集的肥大细胞浸润。这种临床形式因其病变在青春期后持续存在且无全身受累的额外风险而得以区分。我们在此报告一例18个月大的女婴病例,此前无病史。8个月大时首次出现斑丘疹,剧烈瘙痒,椭圆形,褐色病变,中心为浅黄色,质地有弹性,大小不一。对父母的初步询问显示,该婴儿有潮红发作,尤其是由温暖引起的。达里埃氏征为阴性。皮肤活检显示有肥大细胞的真皮浸润,从而确诊为睑黄瘤样肥大细胞增多症。辅助检查以及胰蛋白酶定量均正常。治疗基于排除药物和参与肥大细胞脱颗粒的因素以及使用抗组胺药。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f86/5837140/db1edd673617/PAMJ-28-104-g001.jpg

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