中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (2): 108-112.doi: 10.12144/zgmfskin202502108

• 论著 • 上一篇    下一篇

四例亲毛囊性蕈样肉芽肿临床病理分析

张雪燕1,2,周桂芝1,2,刘永霞1,2,陈声利1,2   

  1. 1山东第一医科大学附属皮肤病医院,山东济南,250022;2山东省皮肤病性病防治研究所,山东济南,250022
  • 出版日期:2025-02-15 发布日期:2025-01-22

Clinical and pathological analysis of 4 cases with folliculotropic mycosis fungoides

ZHANG Xueyan1,2, ZHOU Guizhi1,2, LIU Yongxia1,2, CHEN Shengli1,2   

  1. 1 Hospital for Skin Diseases, Shandong First Medical University, Jinan 250022, China; 2 Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan 250022, China
  • Online:2025-02-15 Published:2025-01-22

摘要: 亲毛囊性蕈样肉芽肿(FMF)皮损表现多样性,早期容易误诊,晚期患者预后一般较差,及时病理活检、早期诊断极其重要。本文回顾性分析2022年8月至2024年2月我院4例FMF患者的临床病理资料,其中男3例,女1例,平均发病年龄51.5岁,平均确诊年龄54.25岁,2例患者皮损始自面部,主要表现为毛囊性丘疹,曾分别被误诊为良性棘层松解性皮肤病、嗜酸性粒细胞增多性皮病。另外2例始自躯干、四肢,主要为斑块,结节,曾分别被误诊为药疹、结缔组织病和湿疹、银屑病。病理组织学主要表现为毛囊周围淋巴样细胞浸润,部分核大、深染。免疫组化示:CD3(+)、CD4(+)、CD5(+)、CD8部分或少许(+);CD30、CD20、CD79a为少许散在阳性或者阴性。4例患者治疗均以口服阿维A胶囊、注射人干扰素、配合UVB/UVA光疗为主,局部斑块处给予浅层X线照射治疗。随访3个月至2年,3例患者依从性较好,继续服用阿维A胶囊,注射人干扰素,病情稳定,1例患者自行改中药治疗后病情加重。

关键词: 亲毛囊性蕈样肉芽肿, 临床病理, 预后

Abstract: The skin lesions of folliculotropic mycosis fungoides (FMF) are diverse and prone to misdiagnosis in the early stages, while the prognosis of late stage patients is generally poor. Timely pathological biopsy and early diagnosis are extremely important. This article retrospectively analyzes the clinical and pathological data of four patients with FMF in our hospital from August 2022 to February 2024. Among them, 3 cases were male and 1 case was female. The average age of onset was 51.5 years and average age of diagnosis was 54.25 years. The skin lesions of the two patients originated from the face, mainly manifested as follicular papules, which were misdiagnosed as benign acantholytic skin disease and eosinophilic dermatosis respectively. The other 2 cases originated from the trunk and limbs, mainly plaques and nodules, and were misdiagnosed as drug eruption, connective tissue disease, eczema, and psoriasis, respectively. The main pathological manifestation is infiltration of lymphoid cells around hair follicles, with some nuclei being large and deeply stained. Immunohistochemistry showed CD3 (+), CD4 (+), CD5 (+), CD8 partially or slightly (+); CD30、CD20 and CD79a slightly scattered positive or negative. The main treatments of the 4 patients were acitretin capsules, human interferon injection, and UVB/UVA phototherapy and superficial X-ray irradiation therapy at the local plaque. The follow-up period was from 3 months to 2 years, 3 patients had good compliance, and continued to take acitretin capsules and inject human interferon, and their condition improved, the other patient changed to traditional Chinese medicine treatment himself, then the condition worsened.

Key words: folliculotropic mycosis fungoides, clinical pathology, prognosis