Sato T, Katagiri K, Itami S, Takayasu S
Department of Dermatology, Oita Medical University, Japan.
J Dermatol. 1996 May;23(5):352-6. doi: 10.1111/j.1346-8138.1996.tb04030.x.
A markedly obese, 41-year-old Japanese man who had suffered from psoriasis vulgaris for several years visited us with elephantiasis-like swelling of his lower legs of three months' duration. His right lower leg showed marked papillomatosis with thick scales, and the left lower leg was eroded and papillomatous. Although direct lymphography of his lower extremities showed no abnormality, indirect lymphography revealed local lymphatic damage in the involved skin. Histological examination showed hyperkeratosis, marked papillomatosis, proliferation of capillaries in the upper dermis, and lymphectasia in the lower dermis. The lesions were much improved by washing and topical use of corticosteroids for two months. It was suspected that obesity and the preceding psoriatic lesions caused local lymphatic disturbances, followed by the development of stasis papillomatosis.
一名41岁的日本男性明显肥胖,患寻常型银屑病数年,因小腿出现持续三个月的象皮肿样肿胀前来就诊。他的右小腿有明显的乳头瘤病,伴有厚鳞屑,左小腿有糜烂和乳头瘤样改变。虽然他下肢的直接淋巴管造影未显示异常,但间接淋巴管造影显示受累皮肤局部淋巴管受损。组织学检查显示角化过度、明显的乳头瘤病、真皮上层毛细血管增生以及真皮下层淋巴管扩张。通过清洗和局部使用皮质类固醇两个月后,病变有明显改善。怀疑肥胖和先前的银屑病病变导致局部淋巴循环障碍,继而发展为淤积性乳头瘤病。