Igawa K, Maruyama R, Satoh T, Yokozeki H, Katayama I, Nishioka K
Department of Dermatology, Tokyo Medical and Dental University, School of Medicine, Japan.
J Dermatol. 1998 Oct;25(10):653-6. doi: 10.1111/j.1346-8138.1998.tb02475.x.
A 62-year-old woman with systemic sarcoidosis developed erythematous plaques on her lower legs. Clinically, two kinds of skin lesions were distinguished; one type formed brownish-red plaques with induration suggesting plaque-type skin sarcoid, and the other formed purplish erythematous plaques with atrophic centers resembling necrobiosis lipoidica. In spite of this clinical appearance, a biopsy specimen from one of the latter lesions revealed typical skin sarcoid histology composed of discrete non-caseating granulomas, while that from one of the other lesions showed necrobiotic changes of collagen bundles surrounded by epitheloid histiocytes and foreign-body giant cells. Because cutaneous involvement of sarcoidosis may mimic necrobiosis lipoidica clinically and/or histologically, we diagnosed her skin lesions as necrobiosis-like skin sarcoid.
一名62岁的系统性结节病女性患者小腿出现红斑性斑块。临床上，区分出两种皮肤损害；一种形成褐色红斑且有硬结，提示斑块型皮肤结节病，另一种形成中心萎缩的紫红色红斑，类似类脂质渐进性坏死。尽管有这样的临床表现，但取自后一种损害之一的活检标本显示典型的皮肤结节病组织学表现，由散在的非干酪样肉芽肿组成，而取自另一种损害之一的标本显示胶原束的渐进性坏死改变，周围有上皮样组织细胞和异物巨细胞。由于结节病的皮肤受累在临床和/或组织学上可能类似类脂质渐进性坏死，我们将她的皮肤损害诊断为类脂质渐进性坏死样皮肤结节病。
