<link rel="stylesheet" href="https://studioyszimg.yxj.org.cn/css/video-js.min.css?v=1"><link rel="stylesheet" href="https://studioyszimg.yxj.org.cn/article/css/base.css?v=5"><link rel="stylesheet" href="https://studioyszimg.yxj.org.cn/article/css/index.css?v=35"><link rel="stylesheet" href="https://ysz-web.yxj.org.cn/live/dist/static/base/index.css?ysz_v=2.0"><script src="https://studioyszimg.yxj.org.cn/js/dsbridge.js?v=13" type="text/javascript"></script><script src="https://ysz-web.yxj.org.cn/dsBridge/main.js?v=26" type="text/javascript"></script><script src="https://ysz-web.yxj.org.cn/live/dist/static/base/fun.js?ysz_v=3" type="text/javascript"></script><script src="https://ysz-web.yxj.org.cn/live/dist/static/js/nativeToWeb.js?v=1" type="text/javascript"></script><div id="ysz-header" style="margin:0;overflow:hidden;"><h1 style="font-size:24px;line-height:1.8;color:#333333;word-wrap:break-word;">​线状萎缩伴色素沉着,会是什么病?| 看图诊断</h1><h2 style="font-size:16px;color:#999999;word-wrap:break-word;"><em style="font-style:normal;margin-right:10px;color:#7f7f7f;display:inline-block;">2022-05-16</em><em style="font-style:normal;margin-right:10px;color:#7f7f7f;display:inline-block;">宋德宇</em><em style="font-style:normal;margin-right:10px;color:#7f7f7f;display:inline-block;">原创:医学界皮肤频道</em></h2></div><p class="brief">看图诊断,快来自测!</p><section style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">诊断难度:⭐⭐⭐</span></section><section><br/></section><section><section><p style="text-align: justify;"><span class="ysz-ueditor-title-one" style="font-size: 16px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">病例简介</span></p><p style="text-align: justify;"><span class="ysz-ueditor-title-one" style="font-size: 16px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;"><br/></span></p></section></section><section><section><section><section><section><section><section><section><section><section><section><section><section></section><section></section><p></p><p></p><section style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">患者22岁,女性,右臂、右侧躯干和右腿单侧分布棕色斑块,病史11年,无自觉症状。皮损处起病之前外伤或炎症。无其他特殊病史及家族史。</span></section><section><br/></section><section style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">查体:右臂、右躯干、右大腿沿Blaschko线呈线状萎缩斑,伴色素沉着,以右大腿处明显,未发现硬化或炎症迹象(图1)。</span></section><section><br/></section><p style="text-align: center;"><img class="rich_pages wxw-img" data-src="https://mmbiz.qpic.cn/mmbiz_png/YvFeD6T0icibIRHJX9zlkjv7eiazZkicDMibK073KxuBdLQrtx8jwI5ZFhVVrgtF1zS0hxHgnIicCAvaTV6icGg3NopRg/640?wx_fmt=png" src="https://studioyszimg.yxj.org.cn/AC14B1A30180CD00E266BD6948E5F797.jpg" alt="图片" style="margin: 0px; padding: 0px; outline: 0px; vertical-align: bottom; box-sizing: border-box ; overflow-wrap: break-word ; width: 677px ; visibility: visible ;"/></p><section style="text-align: center;"><span style="line-height: 28px; font-size: 14px; color: rgb(136, 136, 136);">图1. 右大腿皮肤萎缩、色素沉着(引自参考文献)</span></section><section><br/></section><section style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">实验室检查:血常规、血沉、肾肝功能、自身免疫相关抗体检查均为阴性。</span></section><section><br/></section><section style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">皮损处组织病理:真皮上部血管周围有轻度淋巴细胞浸润,真皮厚度减少,真皮胶原稍致密,附属器未受累(图2)。</span></section><section><br/></section><p style="text-align: center;"><img class="rich_pages wxw-img" data-src="https://mmbiz.qpic.cn/mmbiz_png/YvFeD6T0icibIRHJX9zlkjv7eiazZkicDMibKDtNuBkib1gLXlaLH9s0xnQgIQibcCnLXQDoPQfO9WHcI8ZSOSCcjToMg/640?wx_fmt=png" src="https://studioyszimg.yxj.org.cn/AC14B1A30180CD00E44CEE064A1DB43C.jpg" alt="图片" style="margin: 0px; padding: 0px; outline: 0px; vertical-align: bottom; box-sizing: border-box ; overflow-wrap: break-word ; width: 677px ; visibility: visible ;"/></p><section style="text-align: center;"><span style="line-height: 28px; font-size: 14px; color: rgb(136, 136, 136);">图2. 组织病理:真皮厚度减少,真皮胶原稍致密,真皮上部血管周围有少许淋巴细胞浸润(引自参考文献)</span></section></section></section></section></section></section></section></section></section></section></section></section></section><section><br/></section><section><section><section><section><section><section><section><section><section style="text-align: justify;"><span class="ysz-ueditor-title-one" style="font-size: 16px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">Q:最可能的诊断是什么?</span></section></section></section><section><section><br/></section></section><section><section><section style="text-align: justify;"><span class="ysz-ueditor-title-one" style="font-size: 16px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">A:</span></section></section><section><p></p><p></p><section style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">A. 线状硬皮病</span></section><section style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">B. 线状色素性扁平苔藓</span></section><section style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">C. 进行性特发性皮肤萎缩</span></section><section style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">D. 穆兰线状萎缩性皮病</span></section></section></section></section></section></section></section><section><section><br/></section></section></section></section><section><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; white-space: normal; color: rgb(0, 0, 0); font-family: &quot;Microsoft Yahei&quot;, Helvetica, Arial, sans-serif; text-align: justify; box-sizing: border-box; -webkit-font-smoothing: antialiased; word-spacing: 1px; background-color: rgb(255, 255, 255);"><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; box-sizing: border-box; font-family: PingFangSC, PingFangSC-Regular, &quot;Noto Sans SC&quot;; -webkit-font-smoothing: antialiased;"><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><p style="padding: 0px; overflow-wrap: break-word; font-size: 16px; line-height: 28px; word-break: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><span style="padding: 0px; margin: 0px; overflow-wrap: break-word; box-sizing: border-box; font-family: 微软雅黑; -webkit-font-smoothing: antialiased; background-color: rgb(230, 0, 18); color: rgb(255, 255, 255);">站友们,你们Pick哪一项?欢迎下方留言</span></p></section></section></section></section></section></section><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; white-space: normal; color: rgb(0, 0, 0); font-family: &quot;Microsoft Yahei&quot;, Helvetica, Arial, sans-serif; text-align: justify; box-sizing: border-box; -webkit-font-smoothing: antialiased; word-spacing: 1px; background-color: rgb(255, 255, 255);"><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; box-sizing: border-box; font-family: PingFangSC, PingFangSC-Regular, &quot;Noto Sans SC&quot;; -webkit-font-smoothing: antialiased;"><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><p style="padding: 0px; overflow-wrap: break-word; font-size: 16px; line-height: 28px; word-break: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><br/></p><p style="padding: 0px; overflow-wrap: break-word; font-size: 16px; line-height: 28px; word-break: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><span class="ysz-ueditor-content" style="padding: 0px; margin: 0px; overflow-wrap: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased; line-height: 28px;">PS:留言“选项+选择理由”,版主将挑选出优质评论三名,奖励医米10-20~</span></p><p style="padding: 0px; overflow-wrap: break-word; font-size: 16px; line-height: 28px; word-break: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><span class="ysz-ueditor-content" style="padding: 0px; margin: 0px; overflow-wrap: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased; line-height: 28px;">&nbsp;</span></p><p style="padding: 0px; overflow-wrap: break-word; font-size: 16px; line-height: 28px; word-break: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased;"><span class="ysz-ueditor-content" style="padding: 0px; margin: 0px; overflow-wrap: break-word; box-sizing: border-box; -webkit-font-smoothing: antialiased; line-height: 28px;">明晚九点整,我们在下期文末公布正确答案。</span></p></section></section></section></section><section style="padding: 0px; margin: 0px; max-width: 100%; line-height: 30px; word-break: break-word; overflow-wrap: break-word; white-space: normal !important;"><br/></section></section><section><section><section><section><section><p style="text-align: justify;"><span class="ysz-ueditor-title-one" style="font-size: 16px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">上期答案</span></p></section><section><p><br/></p><p style="text-align: justify;"><strong><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">诊断:C. 播散性Spitz痣</span></strong></p><p><br/></p><p style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">结合临床和病理表现,最终诊断播散性Spitz痣。</span></p><p><br/></p><p style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">该患者有特应性皮炎史,在使用他克莫司软膏后发展为播散性Spitz痣,作者认为特应性皮炎和外用他克莫司可能在该患者播散性Spitz痣的爆发中发挥了作用。故暂停外用他克莫司,每6个月对患者进行皮肤镜密切监测。随访24月后,没有发现可疑的变化。</span></p><p><br/></p><p style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">Spitz痣是以梭形和/或上皮样黑色素细胞为特征的单纯性良性黑素细胞增生性病变。不典型Spitz痣变型包括成簇(聚集性)、播散性或发疹性。</span></p><p><br/></p><p style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">播散性Spitz痣临床很少见,发病原因目前尚不清楚,与创伤、放射治疗、静脉注射药物、怀孕和其他类型的皮肤刺激有关。由于病变数量多且手术解决不可行,因此难以处理。作者建议定期自我检查、皮肤镜随访和全身摄影,并立即手术切除任何可疑的病变。</span></p><p><br/></p><section><section style="text-align: justify;"><span class="ysz-ueditor-content" style="font-size: 16px; line-height: 28px; color: rgb(0, 0, 0);">上期参考文献:<span class="appskip" data-appskip="yxjysz" data-appskipobj="{&quot;type&quot;:18,&quot;id&quot;:0,&quot;title&quot;:&quot;&quot;,&quot;url&quot;:&quot;https://onlinelibrary.wiley.com/doi/10.1111/ijd.15856&quot;}">Didona D, Wolter M, Eming R, et al. Hyperkeratosis lenticularis perstans: a case report of a rare entity. Int J Dermatol. 2021; 60(12): e511-e512.</span></span></section><p><span style="color: rgb(0, 0, 0); font-size: 16px; text-align: justify;"><br/></span></p><p><span style="color: rgb(0, 0, 0); font-size: 16px; text-align: justify;">上期文章链接</span><span style="color: rgb(0, 0, 0); font-size: 16px; text-align: justify;">:《<span class="appskip" data-appskip="yxjysz" data-appskipobj="{&quot;type&quot;:1,&quot;id&quot;:316351,&quot;title&quot;:&quot;暴发性色素性丘疹,会是什么病?|看图诊断&quot;}">暴发性色素性丘疹,会是什么病?| 看图诊断</span></span><span style="color: rgb(0, 0, 0); font-size: 16px; text-align: justify;">》</span></p></section></section></section></section></section></section><p><br/></p><p style="padding: 0px; text-align: justify; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word; font-family: &quot;Microsoft Yahei&quot;, Helvetica, Arial, sans-serif; box-sizing: border-box; -webkit-font-smoothing: antialiased; word-spacing: 1px; background-color: rgb(255, 255, 255);"><span style="padding: 0px; margin: 0px; overflow-wrap: break-word; box-sizing: border-box; font-family: PingFangSC, PingFangSC-Regular, &quot;Noto Sans SC&quot;; -webkit-font-smoothing: antialiased;">点击图片即可进入《看图诊断》专栏,查看更多精彩内容~</span></p><p style="padding: 0px; text-align: justify; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word; font-family: &quot;Microsoft Yahei&quot;, Helvetica, Arial, sans-serif; box-sizing: border-box; -webkit-font-smoothing: antialiased; word-spacing: 1px; background-color: rgb(255, 255, 255);"><span style="padding: 0px; margin: 0px; overflow-wrap: break-word; box-sizing: border-box; font-family: PingFangSC, PingFangSC-Regular, &quot;Noto Sans SC&quot;; -webkit-font-smoothing: antialiased;"><br/></span></p><p style="padding: 0px; text-align: justify; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word; font-family: &quot;Microsoft Yahei&quot;, Helvetica, Arial, sans-serif; box-sizing: border-box; -webkit-font-smoothing: antialiased; word-spacing: 1px; background-color: rgb(255, 255, 255);"><span style="padding: 0px; margin: 0px; overflow-wrap: break-word; box-sizing: border-box; font-family: PingFangSC, PingFangSC-Regular, &quot;Noto Sans SC&quot;; -webkit-font-smoothing: antialiased;"></span></p><div class="appskip-wrap"><p><img class="appskip" data-appskip="yxjysz" data-appskipobj="{&quot;type&quot;:4,&quot;id&quot;:571,&quot;title&quot;:&quot;皮科看图诊断&quot;}" data-yxjysz="1" src="https://studioyszimg.yxj.org.cn/azxua8bgeos.png"/></p><p><br/></p><em class="appskip-icon"></em></div><p style="padding: 0px; text-align: justify; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word; font-family: &quot;Microsoft Yahei&quot;, Helvetica, Arial, sans-serif; box-sizing: border-box; -webkit-font-smoothing: antialiased; word-spacing: 1px; background-color: rgb(255, 255, 255);"></p><p style="padding: 0px; text-align: center; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word; font-family: &quot;Microsoft Yahei&quot;, Helvetica, Arial, sans-serif; box-sizing: border-box; -webkit-font-smoothing: antialiased; word-spacing: 1px; background-color: rgb(255, 255, 255);"><img src="https://studioyszimg.yxj.org.cn/mkbefa9o5t.png" data-src="https://studioyszimg.yxj.org.cn/mkbefa9o5t.png" title="" alt="" style="padding: 0px; margin: 0px auto; border: none; width: auto; box-sizing: border-box; font-family: PingFangSC, PingFangSC-Regular, &quot;Noto Sans SC&quot;; -webkit-font-smoothing: antialiased; display: inline;"/></p><!--auditorInfo-->

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