Priollet P, Deray G, Daniel F, Vayssairat M, Housset E
J Mal Vasc. 1984;9(2):149-53.
The authors report the case of a 10-year-old child with a cutaneous lesion of the thigh present since birth and made up of small translucid raised areas grouped in clumps. The association with these pseudo-vesicles of erysipelatous exacerbations 3 or 4 times a year and the discharge of clear fluid indicative of lymphorrhoea led to a clinical diagnosis of complicated cutaneous lymphangioma. CT scan of the thigh showed absence of spread to deeper layers. This case serves as a basis for discussion of the pathogenic hypothesis of Whimster suggesting that the superficial vesicles are connected to larger lymphatic chambers in the subcutaneous tissue and that the course depends upon pressure variations within these chambers. If this were the case, surgical excision of these lymphatic chambers would be a logical alternative to symptomatic medical treatment of inflammatory episodes.
作者报告了一例10岁儿童病例,其大腿部自出生就有皮肤损害,由成簇的小半透明隆起区域组成。每年有3至4次丹毒样加重发作并伴有这些假性水疱,以及有清亮液体排出提示淋巴漏,这导致临床诊断为复杂性皮肤淋巴管瘤。大腿部CT扫描显示病变未向深层扩散。该病例为讨论Whimster的致病假说提供了依据,该假说认为浅表水疱与皮下组织中较大的淋巴腔相连,且病程取决于这些腔内的压力变化。如果是这样的话,手术切除这些淋巴腔将是对炎症发作进行对症药物治疗的合理替代方案。