Hill P A
Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, Victoria, Australia.
Pathology. 1997 Nov;29(4):434-6. doi: 10.1080/00313029700169495.
A case is reported of a 75-year-old woman, with a past clinical history of granuloma annulare, who developed groups of papulonodular skin lesions on the trunk and face six weeks after returning from a trip to the Mediterranean. The initial biopsy showed a granulomatous dermatitis which was considered consistent with the sarcoidal variant of granuloma annulare, and the lesions were treated with topical and intralesional steroid. A second biopsy performed four months later revealed large numbers of histiocytes containing diagnostic Leishman bodies. It is not clear whether the first biopsy was from a chronic lesion and the second from an acute lesion, or whether local steroid treatment enhanced proliferation of organisms and made a definitive diagnosis possible on the second biopsy.
报告了一例75岁女性病例，该患者既往有环状肉芽肿临床病史，在地中海旅行归来六周后，其躯干和面部出现成群的丘疹结节性皮肤损害。初始活检显示为肉芽肿性皮炎，考虑与环状肉芽肿的结节病样变体相符，皮损采用外用和皮损内注射类固醇进行治疗。四个月后进行的第二次活检显示大量组织细胞中含有可确诊的利什曼原虫小体。尚不清楚第一次活检取材于慢性损害，第二次取材于急性损害，还是局部类固醇治疗促进了病原体增殖，从而使得第二次活检能够做出明确诊断。
