Annular lupus panniculitis on the scalp.
Annular lupus panniculitis on the scalp.
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头皮上的环状狼疮性脂膜炎
DOI：
10.1097/cm9.0000000000000959
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发表时间：
2020-08-05
影响因子：
6.1
通讯作者：
Li JH
中科院分区：
文献类型：
--
作者：
Guo H;Yan HW;Gao XH;Li JH
编者按：一名1岁男童因进行性线状头皮脱发来我科就诊，已持续1个月。体格检查显示，在头皮的右侧顶区和枕区有一宽约1.5厘米的环状脱发斑块[图1A]。皮损光滑，无红斑或鳞片。这位病人没有其他不适。他的病史和家族史都不起眼。实验室检查包括全血细胞计数、尿检、肝肾功能、免疫球蛋白(Ig)、血沉、抗双链DNA、抗Sm、抗Ro/SSA、抗La/SSB抗体检测均正常或阴性。C3组分为0.61g/L(0.79~1.52g/L)，抗核抗体阳性(1：80)。光秃区的组织病理学检查显示真皮深层和附件周围有淋巴细胞和浆细胞渗入[图1B]。皮下组织中也可见粘液沉积和淋巴细胞浸润。阿尔辛蓝染色呈阳性。直接免疫荧光检查显示基底膜区未见Ig G、Ig A、Ig M和C3沉积。根据临床表现和组织学特点，诊断为环状狼疮性脂膜炎，又称深部红斑狼疮，是慢性皮肤红斑狼疮的一种特殊类型。狼疮性脂膜炎的特征是红斑伴皮下深部结节或斑块，常见于面部、躯干或四肢。头皮环状(线性)狼疮性脂膜炎是一种罕见的慢性皮肤红斑狼疮，东亚或高加索人的年轻人更容易受到影响。[1]头皮环状狼疮脂膜炎的典型临床特征是无瘢痕性脱发，无红斑或轻度红斑。病变总是沿着布拉奇科的线分布，呈线状，
To the Editor: A 1-year-old boy presented to our department with progressive linear scalp hair loss that had been present for 1 month. Physical examination revealed an annular alopecic patch of approximately 1.5 cm in width located on right parietal and occipital areas of the scalp [Figure 1A]. The lesion was smooth with no erythema or scales. The patient experienced no other discomfort. His medical history and family history were unremarkable. Laboratory investigations including a complete blood count, urinalysis, liver and renal function, immunoglobulin (Ig), erythrocyte sedimentation rate, antidouble-stranded DNA, anti-Sm, anti-Ro/SSA, and anti-La/SSB antibody determinations were all normal or negative. The C3 component was 0.61 g/L (0.79–1.52 g/L) and the antinuclear antibody was positive (1: 80). Histopathologic examination of the balding area showed infiltrations of lymphocytes and plasma cells in the deep dermis and around appendages [Figure 1B]. Mucinous deposition and lymphocyte infiltrations were also observed in subcutaneous tissue. Alcian blue stain was positive. Direct immunofluorescent examination revealed no deposition of IgG, IgA, IgM, and C3 in the basement membrane zone. According to the clinical manifestation and histologic features, the diagnosis of annular lupus panniculitis was made.Lupus panniculitis, also known as lupus erythematosus profundus, is a special form of chronic cutaneous lupus erythematosus. Lupus panniculitis is characterized by the presence of erythema with deep subcutaneous nodules or plaques and is commonly observed on the face, trunk, or extremities. Annular (linear) lupus panniculitis of scalp is a rare type of chronic cutaneous lupus erythematosus, with young individuals from East Asian or Caucasians being more likely to be affected.[1] Typical clinical features of scalp annular lupus panniculitis include non-scaring alopecia with no or mild erythema.[2] Annular lupus panniculitis mainly materializes as single or multiple sites throughout the scalp in these young patients. The lesions always distribute along Blaschko’s lines and show linear,