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1.5.2 环状肉芽肿
评分与重要性等级:
B
定义
一种表现为环形皮疹的真皮炎性肉芽肿性疾病，常见于儿童和糖尿病患者。
病因和发病机理
不清楚。
症状
坚硬、肤色的小丘疹，呈环形或弧形排列；或为可移动的皮下结节，不伴瘙痒。
定位
好发于四肢的伸侧（尤其是手背和手指），播散型可波及躯干。
实验室检查
播散型需排除糖尿病，且需检测抗线粒体抗体。
皮肤病理学
疏松、变性、淡染的胶原纤维（渐进性坏死）, 其周围有淋巴细胞和组织细胞浸润。
病程
通常自愈，不遗留瘢痕，可复发。
诊断
依据临床特点和组织病理诊断。
鉴别诊断
包括扁平苔藓、肉样瘤病、类脂质渐进性坏死、异物性肉芽肿、结核样型麻风和晚期梅毒（结节性-葡行性梅毒）。
Prevention & Therapy
包括冷冻、糖皮质激素（外用或皮损内注射）、含糖皮质激素硬膏、PUVA（外用或系统），对于播散型，应用氨苯砜、碘化钾和氯喹。
测试
- This 10-year-old child presents with a asymptomatic lesion on the back of this left foot. What systemic disease is associated with the disseminated form of this skin disease?
- True or false?
- Which of these diseases must be considered in the differential diagnosis of granuloma annulare?
- Statement 1 A chest x-ray is always required if granuloma annulare is the diagnosis
- Which is the primary lesion in granuloma annulare?
- 25-year-old lady with hay fever complains of new lesion on back of hand for weeks, spreading slowly. No recent travels. What is the diagnosis?
更多图像 / DOIA
综述文章
- E.W. Piette, M. Rosenbach: Granuloma annulare: Pathogenesis, disease associations and triggers, and therapeutic options (2016)
- E.W. Piette, M. Rosenbach: Granuloma annulare: Clinical and histologic variants, epidemiology, and genetics (2016)
- S.J. Schmieder, C.D. Harper, G.J. Schmieder: Granuloma Annulare (2020)
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