Gosselin P, Delaporte E, Catteau B, Cotten H, Lecomte-Houcke M, Piette F, Bergoend H
Service de Dermatologie A, Hôpital Claude-Huriez, CHRU, Lille.
Ann Dermatol Venereol. 1995;122(10):682-5.
Major trauma was the only aetiologic factor found in a male patient presenting sclerosing lipogranuloma. This condition is well-known in women but is rarely described in men.
A 31-year-old non-obese man with no sign of gynaecomasty presented with well-delimited plaques of pigmented and sclerosous tissue located at the pubis and both breasts as well as hard nodules of the scrotum and the penis. The lesion developed progressively after a major trauma involving the anterior aspect of the thorax and the public area. An inflammatory border persisted eight years after the initial trauma. Histological examination of a biopsy specimen showed evidence of adipocyte necrosis with lipophagia and lipogranuloma. No foreign body was found.
The diagnosis of post-trauma cytosteatonecrosis was retained on the basis of the clinical history and the clinical, histological and radiographic evidence. This condition is a well-identified clinical entity which is sometimes confounded with false panniculitis resulting from self-injection of oily products. The endogenous origin of the fatty acids found within the cytosteatonecrosis tissue has recently been proven. Usual localizations are the breast in women and genital organs in men. Favouring factors in women include obesity, age, anticoagulants, frequency and intensity of trauma. The exceptional localization in our patient was strongly related to the earlier trauma.
一名患有硬化性脂肪肉芽肿的男性患者，主要创伤是唯一发现的病因。这种情况在女性中很常见，但在男性中很少被描述。
一名31岁非肥胖男性，无男性乳房发育迹象，耻骨、双侧乳房出现界限清晰的色素沉着和硬化组织斑块，阴囊和阴茎有硬结。病变在涉及胸部前方和耻骨区域的重大创伤后逐渐发展。初始创伤八年后仍有炎症边界。活检标本的组织学检查显示有脂肪细胞坏死伴噬脂现象和脂肪肉芽肿。未发现异物。
根据临床病史以及临床、组织学和影像学证据，诊断为创伤后细胞性脂肪坏死。这种情况是一种明确的临床实体，有时会与因自行注射油性产品导致的假性脂膜炎相混淆。细胞性脂肪坏死组织中发现的脂肪酸的内源性起源最近已得到证实。常见的发病部位在女性为乳房，在男性为生殖器官。女性的诱发因素包括肥胖、年龄、抗凝剂、创伤的频率和强度。我们患者这种特殊的发病部位与早期创伤密切相关。
