An Outbreak of Eruptive Pseudoangiomatosis-Like Lesions due to Mosquito Bites: Erythema punctatum Higuchi
An Outbreak of Eruptive Pseudoangiomatosis-Like Lesions due to Mosquito Bites: Erythema punctatum Higuchi
复制标题
蚊虫叮咬引起的爆发性假性血管瘤样病变的爆发：樋口点状红斑
DOI：
10.1159/000077850
复制
发表时间：
2004
期刊：
影响因子：
3.4
通讯作者：
Y. Kitajima
中科院分区：
文献类型：
--
作者：
M. Ban;Y. Ichiki;Y. Kitajima
在过去的大约50年里，日本将被贫血晕包围的不发痒的小斑点红斑称为Higuchi点状红斑。皮疹的临床特征描述如下[1-6]。女性比男性更经常受到影响。大多数皮疹在四肢分散发展，特别是在夏天。硬结在发病时伴有红斑和晕圈，并在约3天内消失。4或5天后，光晕变得不清晰。红斑和晕圈在发病后7-19天消失。在面部，病变有不清楚的光环。其病因尚不清楚。组织学研究[3，4，6]显示真皮上层毛细血管扩张和炎性细胞浸润，这不是特异性特征。大原等[5]报道了24例病例，并提出蚊虫叮咬在Higuchi点状红斑的发病机制中起重要作用。他们还观察到，一名30岁的女性患者在被淡色库蚊叮咬5分钟后皮肤出现皮疹，并观察到3例由其他种类的蚊子引起的病例。然而，到目前为止，还没有其他关于蚊子和红斑点状Higuchi之间关系的报道。自1990年以来，我们观察了几个门诊病人类似的爆发在端岛市医院，这是位于一个花园城市在诺维平原附近的日本，在每年夏天。皮疹对皮质类固醇软膏没有反应，在治疗或不治疗的情况下在1-3周内消退。虽然我们几乎没有看到在医院的住院病人爆发，我们最近经历了许多住院病人与这些爆发。大量的C。2001年秋末，虽然端岛市通常没有蚊子出现，但白翅天蛾袭击了端岛市医院，特别是在夜间飞入医院。C.直到12月底，苍白风笛一直让住院患者和医院工作人员感到担忧。C. pipiens pallens在日本很常见。当被它们咬伤时，人们通常会感到痒。我们怀疑C.白喉笛是由二〇 〇一年在医院附近进行的渠务工程引致。蚊子在不流动的水沟里滋生. C.淡色库蚊度过了冬天，2002年早春再次出现在端岛市立医院。而C.在2001年秋末和2002年春初，我们发现了许多患有Higuchi点状红斑的住院患者：10例住院患者和16例住院患者（表1）。他们的面部、颈部、手部和前臂有多处损伤。这些不痒。除精神科住院病人外，大多数病人卧床不起。同一楼层的五名住院患者在10天内出现皮疹。其中两人曾住在同一个房间，并被发现在同一天爆发。在那层楼里出现了一些混乱，因为大多数医生和护士都不知道点状红斑Higu-
Nonitchy small spotted erythema surrounded by an anemic halo (fig. 1) has been called erythema punctatum Higuchi in Japan for about the past 50 years. The clinical features of the eruptions are described as follows [1–6]. Females are more frequently affected than males. Most of the eruptions develop scatteringly on the extremities, especially in summer. Indurations are associated with erythema and halos at the onset, and vanish in about 3 days. Halos become unclear after 4 or 5 days. Both the erythema and the halo disappear 7–19 days after the onset. On the face, lesions have an unclear halo. The etiology is not well known. Histological studies [3, 4, 6] revealed capillary dilatation and inflammatory cell infiltration in the upper dermis, which are not specific features. Ohara et al. [5] reported 24 cases and suggested that mosquito bites play a significant role in the pathogenesis of erythema punctatum Higuchi. They also observed that the eruption appeared in the skin of a 30-year-old female patient 5 min after the bite of Culex pipiens pallens and saw 3 cases induced by other kinds of mosquitoes. However, to date there have been no other reports about the relationship between mosquitoes and erythema punctatum Higuchi. Since 1990, we have observed several outpatients with similar eruptions in Hashima City Hospital, which is located in a garden city in the Nobi plains near the center of Japan, during every summer. The eruptions do not react to corticosteroid ointments and fade out within 1–3 weeks with or without therapy. Though we had hardly seen the eruptions in inpatients of the hospital, we have recently experienced many inpatients with these eruptions. A great number of C. pipiens pallens attacked Hashima City Hospital in the late autumn of 2001 and flew into the hospital especially at night, though no mosquitoes usually appear in Hashima City in that season. C. pipiens pallens worried the inpatients and the staff of the hospital until the end of December. C. pipiens pallens is common in Japan. When bitten by them, people usually feel an itch. We suspected that the propagation of C. pipiens pallens was caused by drainage works that had been carried out near the hospital in 2001. The mosquitoes breed in the stagnant ditch. C. pipiens pallens passed the winter and appeared again in Hashima City Hospital in the early spring of 2002. While a great number of C. pipiens pallens attacked the hospital, we found many inpatients with erythema punctatum Higuchi: 10 inpatients in the late autumn in 2001, and 16 inpatients in the early spring of 2002 (table 1). They had multiple lesions on the face, neck, hands and forearms. These were not itchy. Most of the patients except for psychiatric inpatients were bedridden. Five inpatients on the same floor developed the eruptions within 10 days. Two of them had stayed in the same room and were found to develop the eruptions on the same day. Some confusion arose on that floor, because most doctors and nurses had no knowledge of erythema punctatum Higu-