Morgado Francisca, Batista Mariana, Coutinho Inês, Cardoso José Carlos, Tellechea Óscar
Department of Dermatology, Coimbra University Hospital, Coimbra.
Dermatol Online J. 2018 Dec 15;24(12):13030/qt2f31g4pv.
A 41-year-old woman presented with a violaceous papule on the dorsum of the hand, large ipsilateral axillary lymphadenopathy, and tender, erythematous, subcutaneous nodules on the legs. Accompanying signs included fever, ankle swelling, and bilateral red eye. She recalled having a previous exposure to kittens one month before and had a positive family history for sarcoidosis. Histological examination of the hand lesion showed sarcoidal granulomas with positive Bartonella henselae DNA, whereas a biopsy done on the leg nodules was compatible with erythema nodosum. Cat scratch disease (CSD) typically presents as a tender regional lymphadenopathy preceded by an inoculation papule with spontaneous resolution occurring between 8-16 weeks. Cutaneous manifestations of CSD are rare, with erythema nodosum accompanying only 0.6% of cases. Although speculative, the background of a positive family history for sarcoidosis may explain the atypical presentation of this case, with red eye, persistent arthralgia, and associated sarcoidal granulomas.
一名41岁女性，手部背侧出现一个紫红色丘疹，同侧腋窝有肿大淋巴结，腿部有压痛性、红斑性皮下结节。伴随症状包括发热、脚踝肿胀和双眼发红。她回忆起一个月前曾接触过小猫，且有结节病家族史。手部病变的组织学检查显示为结节样肉芽肿，巴尔通体DNA呈阳性，而腿部结节活检结果符合结节性红斑。猫抓病（CSD）通常表现为接种丘疹后出现压痛性局部淋巴结肿大，8 - 16周内可自行消退。CSD的皮肤表现罕见，仅0.6%的病例伴有结节性红斑。尽管具有推测性，但结节病家族史这一背景可能解释了该病例的非典型表现，包括眼红、持续性关节痛以及相关的结节样肉芽肿。
