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中华实验和临床感染病杂志(电子版)

中华实验和临床感染病杂志(电子版) ›› 2017, Vol. 11 ›› Issue (04) : 368 -372. doi: 10.3877/cma.j.issn.1674-1358.2017.04.011

临床论著

婴儿瘰疬性苔藓5例
张斌1, 王珊1, 禇岩1, 马琳1, 徐子刚1, 邢嬛1,†()   
  1. 1. 100045，北京，首都医科大学附属北京儿童医院皮肤科，儿科学国家重点学科，儿科重大疾病研究教育部重点实验室
  • 收稿日期:2017-05-27 出版日期:2017-08-15
  • 通信作者: 邢嬛
  • 基金资助:
    北京市医院管理局临床医学发展专项(No. ZYLX201601); 国家自然科学基金(No. 81673042)

Five cases of infants lichen scrofulosorum

Bin Zhang1, Shan Wang1, Yan Chu1, Lin Ma1, Zigang Xu1, Huan Xing1,†()   

  1. 1. Department of Dermatology, Beijing Children’s Hospital, Capital Medical University, Pediatrics National Key, Disciplines, Ministry of Education Key Laboratory of Major Pediatric Disease Research, Beijing, 100045, China
  • Received:2017-05-27 Published:2017-08-15
  • Corresponding author: Huan Xing
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引用本文：

张斌, 王珊, 禇岩, 马琳, 徐子刚, 邢嬛. 婴儿瘰疬性苔藓5例[J]. 中华实验和临床感染病杂志(电子版), 2017, 11(04): 368-372.

Bin Zhang, Shan Wang, Yan Chu, Lin Ma, Zigang Xu, Huan Xing. Five cases of infants lichen scrofulosorum[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(04): 368-372.

目的

总结5例婴儿瘰疬性苔藓的临床和病理特点。

方法

回顾性分析2015年至2016年于北京儿童医院皮肤科门诊就诊的5例婴儿瘰疬性苔藓患者的临床和病理资料。

结果

5例患儿均为卡介苗接种后表现为躯干和（或）四肢皮色至淡红色毛囊性小丘疹，表面附着少许鳞屑。5例患儿行结核分枝杆菌感染和免疫功能筛查均为阴性。皮肤病理提示为真皮上部毛囊或汗管周围上皮样肉芽肿，可见上皮样细胞及少许郎罕巨细胞，周围有淋巴细胞浸润。

结论

5例患儿随访半年，皮损自然消退，未给予任何治疗。仅1例患儿前胸遗留少许炎症后色素沉着。

关键词: 瘰疬性苔藓, 卡介苗, 儿童
Objective

To investigate the clinical and pathological characteristics of five infants with lichen scrofulosorum (LS).

Methods

The clinical and pathological data of 5 outpatients of infants with LS who were admitted to Beijing Children’s Hospital, Capital Medical University from 2015 to 2016 were analyzed, retrospectively.

Results

After receiving Bacillus Calmette Guerin (BCG) vaccinations, all patients presented with tiny, skin-coloured to erythematous perifollicular papules over the trunk and extremities, with scales on the surface. All 5 patients showed negative results for tuberculosis infection and immune deficiency tests. Histopathologic examination of 5 patients showed distinctive features, including the epidermal granuloma in the upper-dermis, usually in the vicinity of hair follicles and suboriferous, which were composed of epithelioid cells with a few Langhans giant cells and lymphocytes at the periphery.

Conclusions

Lichen scrofulosorum of 5 patients resolved spontaneously in half a year without any treatment, excluding 1 case with hyperpigmentation on the chest.

Key words: lichen scrofulosorum, Bacillus Calmette Guerin (BCG), Children
表1 5例LS患儿的临床资料
病例 性别 年龄 病程 并发症 皮损分布 皮损形态
1 女 3个月3 d 30 d 无 腹部 与毛囊一致的粟粒大小丘疹，平顶，呈蛙卵状簇集分布，可见皮损消退后轻度萎缩性斑点
2 女 5个月 3 d 特应性皮炎 前胸 与毛囊一致的针尖至粟粒大小淡红色丘疹，成簇分布并融合趋势，少数丘疹顶端覆少许细小鳞屑
3 女 3个月17 d 14 d 婴儿血管瘤 腹部 与毛囊一致针尖至粟粒大小皮色丘疹，单个散在分布
4 女 4个月21 d 90 d 无 前胸、腹部、后背、四肢 粟粒大小淡红色丘疹，成簇分布，部分发展皮色萎缩性斑片，表面可见稍凹陷
5 男 3个月5 d 5 d 传染性软疣 左上臂 针尖大小皮色丘疹，成簇分布，表面干燥，少部分丘疹顶端覆少许细小鳞屑
图1 瘰疬性苔藓患儿1腹部皮损
图2 瘰疬性苔藓患儿2颈部和前胸皮损
图3 瘰疬性苔藓患儿4前胸和腹部皮损
图4 瘰疬性苔藓患儿1皮损组织病理像
表2 5例LS患儿实验室检查及辅助检查结果
病例 PPD ESR T-SPOT.TB 胸片 CDs/Igs 皮肤病理
1 N N N N N A
2 ND N N N N A
3 N N N N N A+B
4 N N N N N A
5 ND N N N N A
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