Xing Yaqiong, Xie Jun, Jiang Si, Upasana Manandhar, Song Jiquan
The Dermatology, Wuhan University Zhongnan Hospital, Wuhan, Hubei, China.
J Cosmet Dermatol. 2019 Oct;18(5):1560-1563. doi: 10.1111/jocd.12869. Epub 2019 Jan 29.
The incidence rate of psoriasis vulgaris (PSV) coexisting with Juvenile dermatomyositis (JDM) is low. Through our thorough literature search, we found that PSV arising on JDM with superficial fungal infection of facial skin is rarely reported. So, we hereby, report a case of combination of the above three diseases. Meanwhile, we also reviewed the previous literatures aiming at the related basis, clinical manifestation, diagnosis, and treatment of the diseases. Interestingly, of all cases, this case is the only one in which the symptom of muscle weakness preceded the appearance of rash.
A 21-year-old man diagnosed with JDM 6 years ago came to our inpatient department due to the appearance of new rash. Skin examination showed some sharply demarcated scaly plaques over the head, neck, torso, and bilateral upper limbs with pruritus and scaling. Histological examination and typical clinical manifestation confirmed the diagnosis of PSV for his new rash. Family history was negative for JDM and PSV. The clear erythema located on his face revealed the existence of superficial fungal infection with the help of fungal fluorescence microscopy. He had marked improvement of his symptoms with the treatment given at our department. In the past 3 months, the patient has been on regular follow-up at our outpatient department, and his condition is stable at present.
This paper presents a case of PSV arising on JDM coexisting with superficial fungal infection on the face hoping that this will help clinicians in the better diagnosis of the diseases during literature search.
寻常型银屑病（PSV）与幼年皮肌炎（JDM）并存的发病率较低。通过全面的文献检索，我们发现JDM合并面部皮肤浅表真菌感染并出现PSV的情况鲜有报道。因此，我们在此报告一例上述三种疾病合并的病例。同时，我们还回顾了以往关于这些疾病的相关基础、临床表现、诊断和治疗的文献。有趣的是，在所有病例中，该病例是唯一一例肌无力症状先于皮疹出现的。
一名6年前被诊断为JDM的21岁男性因出现新发皮疹前来我院住院部就诊。皮肤检查显示头部、颈部、躯干及双侧上肢有一些边界清晰的鳞屑性斑块，伴有瘙痒和脱屑。组织学检查及典型临床表现确诊其新发皮疹为PSV。家族史中JDM和PSV均为阴性。其面部清晰的红斑在真菌荧光显微镜检查的帮助下显示存在浅表真菌感染。在我院接受治疗后，他的症状有明显改善。在过去3个月里，该患者一直在我院门诊定期随访，目前病情稳定。
本文报告了一例JDM合并面部浅表真菌感染并出现PSV的病例，希望这将有助于临床医生在文献检索过程中更好地诊断这些疾病。
