Cheng De-Jin, Zheng Xiang-Yue, Tang Shui-Fu
First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China.
Division of Ophthalmology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China.
World J Clin Cases. 2020 Feb 6;8(3):600-605. doi: 10.12998/wjcc.v8.i3.600.
Cutaneous epithelioid angiomatous nodules (CEAN) are rare, benign, vascular lesions characterized by benign proliferation of endothelial cells with prominent epithelioid features, which can be easily confused with benign and malignant vascular tumors. However, the etiology of CEAN remains unclear, and no association with infection, trauma, or immunosuppression has been described. This case study indicated that CEAN is closely related to the patient's impaired immune status and may be induced by cyclosporine.
A 19-year-old boy with nephrotic syndrome (NS) developed large CEAN on the left foot during treatment for NS. He had repeated relapses of edema in the past 6 years and different types of immunosuppressants were administered including methylprednisolone, mycophenolate mofetil, tacrolimus and cyclosporine; the dosages of these drugs were frequently adjusted. The patient had been receiving cyclosporine and methylprednisolone for 7 mo before he developed CEAN. Cyclosporine was discontinued due to its side effects on skin. After cessation of cyclosporine and 16 mo follow-up, the nodules gradually disappeared without any other treatment for the CEAN.
Impaired immune status is proposed to be a risk factor for CEAN, which may be induced by cyclosporine.
皮肤上皮样血管性结节（CEAN）是一种罕见的良性血管病变，其特征为内皮细胞良性增生并具有显著的上皮样特征，容易与良性和恶性血管肿瘤相混淆。然而，CEAN的病因仍不清楚，尚未有与感染、创伤或免疫抑制相关的报道。本病例研究表明，CEAN与患者免疫状态受损密切相关，可能由环孢素诱发。
一名19岁的肾病综合征（NS）男孩在NS治疗期间左足出现了大的CEAN。在过去6年中，他反复出现水肿，并使用了包括甲泼尼龙、霉酚酸酯、他克莫司和环孢素在内的不同类型免疫抑制剂；这些药物的剂量经常调整。该患者在出现CEAN之前已接受环孢素和甲泼尼龙治疗7个月。由于环孢素对皮肤的副作用，停用了环孢素。停用环孢素并随访16个月后，结节逐渐消失，未对CEAN进行任何其他治疗。
免疫状态受损被认为是CEAN的一个危险因素，可能由环孢素诱发。
