Goldberg L J, Goldberg N, Abrahams I, Silvers D N, Szaniawski W, Halperin A J
Division of Dermatology, Albert Einstein College of Medicine, New York, NY.
J Cutan Pathol. 1994 Feb;21(1):47-51. doi: 10.1111/j.1600-0560.1994.tb00690.x.
Giant cell lichenoid dermatitis is a recently described dermatosis thought to be an unusual lichenoid drug eruption. It is characterized by a generalized, pruritic, papulosquamous eruption sparing palms, soles, face and mucous membranes. Histopathologic findings include areas of epidermal hyperplasia and atrophy with focal vacuolar alteration of the basal layer, exocytosis and cytoid body formation. The dermis contains a band-like, mononuclear cell infiltrate at the dermoepidermal junction with admixed eosinophils, plasma cells and large multinucleate cells. The histologic differential diagnosis includes infectious processes, sarcoidosis, lichen nitidus, lupus erythematosus and lichen planus. We report 3 patients with giant cell lichenoid dermatitis, one of whom was subsequently diagnosed as having sarcoidosis. Because giant cell lichenoid dermatitis may resemble sarcoidosis both clinically and histologically, and because cutaneous sarcoid is often associated with systemic involvement, the diagnosis of sarcoid should be strongly considered in patients with giant cell lichenoid dermatitis.
巨细胞苔藓样皮炎是一种最近才被描述的皮肤病，被认为是一种不寻常的苔藓样药疹。其特征为全身性、瘙痒性丘疹鳞屑性皮疹，不累及手掌、足底、面部和黏膜。组织病理学表现包括表皮增生和萎缩区域，伴有基底层局灶性空泡改变、细胞外渗和细胞样体形成。真皮在真皮表皮交界处有带状单核细胞浸润，并伴有嗜酸性粒细胞、浆细胞和大型多核细胞。组织学鉴别诊断包括感染性病变、结节病、光泽苔藓、红斑狼疮和扁平苔藓。我们报告了3例巨细胞苔藓样皮炎患者，其中1例随后被诊断为结节病。由于巨细胞苔藓样皮炎在临床和组织学上可能与结节病相似，且皮肤结节病常伴有全身受累，因此对于巨细胞苔藓样皮炎患者应高度考虑结节病的诊断。
