本文選題：硬斑病 + 硬化性萎縮性苔蘚�。� 參考：《大連醫(yī)科大學(xué)》2015年碩士論文

【摘要】：背景:硬斑病(morphea)又稱局限性硬皮病(localized scleroderma,LS),以真皮增厚或硬化伴皮下脂肪缺失為特征的自身免疫性疾病。女性多見,其確切病因尚不明確,可能與外界因素、遺傳、自身免疫等有關(guān)。硬斑病雖不累及內(nèi)臟器官,沒有雷諾現(xiàn)象和甲襞毛細血管的變化,但是LS也可累及皮下脂肪,筋膜,肌肉和骨骼,影響關(guān)節(jié)活動甚至致殘,發(fā)生在頭面部時可出現(xiàn)神經(jīng)系統(tǒng)和眼部并發(fā)癥。分為5個亞型:局限型硬斑病、線狀硬斑病、泛發(fā)性硬斑病、全身性硬化性硬斑病和混合性硬斑病。硬斑病和硬化性萎縮性苔癬(Lichen sclerosus et atrophicus,LSA)的關(guān)系目前尚存在爭議,兩者的臨床表現(xiàn)和組織病理特征相似,均是以皮膚纖維化為特征的慢性炎癥性皮膚病,猜測此兩種疾病是同一疾病譜的兩種不同表現(xiàn)形式。硬斑病的診斷主要根據(jù)病史、臨床表現(xiàn)、組織病理學(xué)檢查。硬斑病早期治療效果較好,治療主要包括局部治療、系統(tǒng)用藥、光療、物理治療等。橋本氏甲狀腺炎(Hashimoto’S thyroiditis,HT)又稱慢性淋巴細胞性甲狀腺炎,是最常見自身免疫性甲狀腺疾病。硬斑病和橋本均屬自身免疫性疾病,且病因均可能與外界環(huán)境、自身免疫、遺傳等有關(guān),免疫性疾病之間可相互關(guān)聯(lián),硬斑病患者患自身免疫性疾病概率較正常人高,與硬斑病相關(guān)的自身免疫性疾病包括糖尿病、橋本氏甲狀腺炎、Graves病、白癜風(fēng)、潰瘍性結(jié)腸炎、銀屑病等。硬斑病等自身免疫性疾病的病因以及相互之間的關(guān)聯(lián)機制有待明確。病例報告:例1女,64歲,頸前、軀干和雙脛皮疹5年,會陰部皮疹伴瘙癢4年,既往橋本氏甲狀腺炎病史9年。體檢:甲狀腺I度腫大,質(zhì)韌,無突眼、脛前粘液水腫等表現(xiàn)。頸部、前胸淡紅色斑片,后背部硬化萎縮,會陰部瓷白色斑塊。組織病理提示:(前胸)硬斑病,(外陰)硬化性萎縮性苔蘚。例2女,例1的妹妹,55歲,左乳下及腹部皮膚逐漸硬化萎縮4年,既往橋本氏甲狀腺炎病史3年。體檢:甲狀腺I度腫大,質(zhì)韌,無突眼、脛前粘液水腫等表現(xiàn)。左乳下、腹部和后背中央皮膚色素減退,硬化萎縮。組織病理提示:硬斑病。根據(jù)臨床特點、組織病理、過碘酸-雪夫染色和甲狀腺功能檢查,2例均診斷為硬斑病合并橋本氏甲狀腺炎。結(jié)論:首次報道了同一家族中姐妹同患硬斑病合并橋本氏甲狀腺炎病例。從本報道家系譜中表明硬斑病和橋本氏甲狀腺炎可能具有遺傳性,自身免疫性疾病在同一家族、同一患者可同時并發(fā),提示臨床在診斷硬斑病時,應(yīng)注意檢測甲狀腺功能并注意有無其他自身免疫性疾病病史和家族史。
[Abstract]:Background: (morphea), also known as localized scleroderma LS, is an autoimmune disease characterized by dermis thickening or sclerosis with subcutaneous fat deficiency. Women are more common, its exact cause is not clear, may be related to external factors, heredity, autoimmunity and so on. Although scleroplakia does not involve visceral organs, there is no Reynolds phenomenon or changes in nailfold capillaries, but LS can also involve subcutaneous fat, fascia, muscles and bones, affecting or even disabling joint activity. Neurological and ocular complications can occur in the head and face. It is divided into 5 subtypes: localized hard spot disease, linear hard spot disease, generalized hard spot disease, systemic sclerosing hard spot disease and mixed hard spot disease. The relationship between sclerosing sclerosus and lichen sclerosus (Lichen sclerosus et atrophicus) is still controversial. Their clinical manifestations and histopathological features are similar. Both of them are chronic inflammatory dermatosis characterized by skin fibrosis. It is assumed that the two diseases are two different manifestations of the same disease spectrum. The diagnosis of scleroplakia is mainly based on the history, clinical manifestation and histopathological examination. The early treatment of hard spot disease includes local treatment, systemic medication, phototherapy, physical therapy and so on. Hashimoto's thyroiditis (Hashimoto's thyroiditis HT), also known as chronic lymphocytic thyroiditis, is the most common autoimmune thyroid disease. Scleroplakia and Hashimoto are autoimmune diseases, and the etiology may be related to external environment, autoimmunity, heredity and so on. The incidence of autoimmune diseases in patients with scleroplakia is higher than that in normal subjects. Autoimmune diseases associated with scleroplakia include diabetes, Hashimoto's thyroiditis, Graves' disease, vitiligo, ulcerative colitis, and psoriasis. The etiology and mechanism of autoimmune diseases such as scleroplakia need to be clarified. Case report: case 1 female, aged 64 years, 5 years old with anterior cervical, trunk and double shank rash, perineal rash with pruritus for 4 years, and previous history of Hashimoto's thyroiditis for 9 years. Physical examination: thyroid I degree swelling, quality tough, no exophthalmos, anterior tibial mucus edema and other manifestations. Neck, anterior chest light red spot, posterior back hardening atrophy, perineum porcelain white plaque. Histopathological cues: hard spot disease (vulva) sclerosing atrophic lichen. Case 2 female, sister of case 1 55 years old, left submammary and abdominal skin sclerosis and atrophy for 4 years, previous history of Hashimoto's thyroiditis for 3 years. Physical examination: thyroid I degree swelling, quality tough, no exophthalmos, anterior tibial mucus edema and other manifestations. Hypopigmentation of the skin in the left lower breast, abdomen and the center of the back, sclerosis and atrophy. Histopathological cues: hard spot disease. According to clinical features, histopathology, periodate-Scheffer staining and thyroid function examination, 2 cases were diagnosed as hard spot disease with Hashimoto's thyroiditis. Conclusion: a case of Hashimoto's thyroiditis with hard spot disease among sisters in the same family is reported for the first time. From the pedigree of the Taoist family of this newspaper, it is suggested that hard spot disease and Hashimoto's thyroiditis may be hereditary, that autoimmune diseases are in the same family and the same patient can be concomitant at the same time, suggesting that clinical diagnosis of hard spot disease, Attention should be paid to the detection of thyroid function and to the history of other autoimmune diseases and families.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R581.4;R593.25

【相似文獻】

相關(guān)期刊論文 前10條

1 湯愛民;;大皰性深在性硬斑病[J];國外醫(yī)學(xué).皮膚病學(xué)分冊;1987年04期

2 繆愛平,方起鵬;音頻治療儀治愈硬斑病1例報告[J];臨床皮膚科雜志;1995年05期

3 顧有守;;硬斑病的治療進展[J];皮膚性病診療學(xué)雜志;2011年05期

4 崔冬梅;兒童殘廢型全硬化性硬斑病一例[J];蘭州醫(yī)學(xué)院學(xué)報;1994年03期

5 劉力;限局性硬斑病患者中自身免疫病發(fā)生率的調(diào)查[J];國外醫(yī)學(xué).皮膚病學(xué)分冊;1990年05期

6 孫秋寧;杜偉;胡彬;劉排;苑勰;;兒童局限性硬皮病的臨床特點[J];中國醫(yī)學(xué)科學(xué)院學(xué)報;2009年01期

7 褚美琴;;泛發(fā)型硬斑病1例[J];中國醫(yī)學(xué)文摘(皮膚科學(xué));2013年03期

8 田華,李東霞,李蘭英,李治;多發(fā)性硬斑病致功能障礙一例[J];中華皮膚科雜志;1996年06期

9 劉隨;兒童致殘性全硬化性硬斑病1例[J];皮膚病與性病;2004年03期

10 馮文利;姚鳳玲;馬鐵牛;;致殘性全硬化性硬斑病1例[J];中國中西醫(yī)結(jié)合皮膚性病學(xué)雜志;2006年04期

相關(guān)會議論文 前2條

1 孫秋寧;杜偉;胡彬;劉排;苑勰;;兒童局限性硬皮病的臨床特點[A];2009全國中西醫(yī)結(jié)合皮膚性病學(xué)術(shù)會議論文匯編[C];2009年

2 張春艷;許愛娥;;硬斑病合并白癜風(fēng)1例[A];2013全國中西醫(yī)結(jié)合皮膚性病學(xué)術(shù)年會論文匯編[C];2013年

相關(guān)碩士學(xué)位論文 前1條

1 劉金鵬;姐妹同患硬斑病合并橋本氏甲狀腺炎二例并文獻復(fù)習(xí)[D];大連醫(yī)科大學(xué);2015年

，

本文編號：2111492