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1 病历摘要患儿男,20个月。右手腕出现暗红色斑块20个月。患儿出生时发现右手腕屈侧有一钱币大的暗红色斑块,边界清楚,皮损随年龄增大缓慢增大,皮损遇热水或遇风会突然变为鲜红色,伴肿胀,无水疱形成,无面部、全身潮红,无恶心、呕吐、腹痛等不适;摩擦刺激后可出现水疱,水疱约1周后可自行消退。患儿足月剖宫产,母乳喂养,无其他疾病史;患儿父母身体健康,非近亲结婚,家族中无类似疾病患者。体格检查:一般情况良好,全身浅表淋巴结未触及增大,各系统检查未见异常。皮肤科检查:右手腕屈侧可见一暗红色核桃大斑块,边界清楚,表面呈橘皮样改变(图1A),触之呈橡皮样硬度。皮损组织病理检查:表皮大致正常,角化过度,真皮中上部可见大量形态、大小较一致的单一核细胞弥漫性浸润,胞核圆形或卵圆形,胞质淡染,胞质内可见嗜酸性颗粒,伴少许嗜酸性粒细胞浸润(图1B、C)。Giemsa染色:胞质中可见紫红色异染颗粒(图1D)。
1 medical records abortion male, 20 months. Dark red patches appear on the right wrist for 20 months. Children born at the wrist was found on a large dark red cashmere plaque, the border is clear, the lesion increases slowly with age, skin lesions encountered hot water or the wind will suddenly become bright red, with swelling, no Blisters formed, no facial, body flushing, no nausea, vomiting, abdominal pain and other discomfort; rubbing may occur after blisters, blisters about 1 week after their own subsided. Children with full-term cesarean section, breastfeeding, no other history of illness; children with healthy parents, non-relatives married, no similar family disease patients. Physical examination: generally good, systemic superficial lymph nodes did not touch increases, the system check no abnormalities. Dermatology examination: the right wrist showed a dark red walnut large plaque, the border is clear, the surface was orange-like changes (Figure 1A), the contact was rubber-like hardness. Skin lesions histological examination: the epidermis is roughly normal, hyperkeratosis, the upper part of the dermis can be seen in a large number of morphological, uniform size of uniform diffuse infiltration of mononuclear cells, nucleus round or oval, pale cytoplasm, visible Eosinophilic granules with little eosinophil infiltration (Figure 1B, C). Giemsa staining: Fuchsia heterochromatic particles are visible in the cytoplasm (Figure 1D).