摘要
To the Editor:A 50-year-old man presented with a 1-month history of pruritic papules and nodules on his trunk and extremities.The patient had a 20-year history of alcoholism,and a 10-year history of Meniere’s disease.He was treated with intravenous sodium aescinate for 5 days because of Meniere’s disease 2 months ago.Other chronic diseases or special family histories were denied.Upon physical examination,red or brown papules,and nodules with diameter of 3 to 5 mm were noted on his limbs,shoulders,and dorsum,with central umbilicated necrosis,or keratin plug,accompanied by Kobner Phenomenon[Figure 1A].Ultrasonic examination,peripheral blood cell count and biochemical examination were basically normal.Dermoscopic examination revealed a red-brown structureless area covered with crusts and scales centrally,surrounded by a white rim,and a reddish inflammatory circle with looped and dotted vessels peripherally in polarization mode[Figure 1B].Histopathology showed neutrophils and degenerated keratin components in central goblet necrotic epidermis,degenerated collagen fibers beneath the necrotic epidermis,and sheet of lymphocytes and scattered eosinophils around blood vessels in the dermis[Figure 1C].Masson staining[Figure 1D]and Verhoeff-van Gieson staining[Figure 1E]confirmed the penetration of collagen fibers and fragmented elastic fibers in the necrotic epidermis.Acquired reactive perforating collagenosis was diagnosed,which reacted well to 5-week treatment of oral anti-histamines,topical steroids,and narrow-band ultraviolet B.The patient reported clearance of the lesions for 4 months,but recurrence after alcohol intake again in telephone follow-up.
作者简介
Correspondence to:Jiang Jin,Department of Dermatology,Peking University People's Hospital,Beijing 100044,China.E-Mail:jiangjin@yahoo.com。
