每日一题_2022.11.06

A 5-year-old boy from China with a history of IgA vasculitis at 2 years of age presented with a 1-month history of progressively painful skin ulcerations on his extremities. Two months prior, he had had an episode of nasal pustules that had not responded to antimicrobial therapy or surgical débridement, but had ultimately improved with 2 days of systemic glucocorticoid therapy. At the current presentation, laboratory and radiographic studies showed no signs of underlying systemic disease, such as cancer, inflammatory bowel disease, or autoimmune conditions. Biopsy samples from the lesions showed a dense neutrophilic infiltrate with negative tissue cultures. What is the diagnosis?

一名来自中国的 5 岁男孩，2 岁时有 IgA 血管炎病史，因四肢皮肤溃疡进行性疼痛 1 个月就诊。 两个月前，他有一次鼻脓疱发作，对抗菌治疗或手术清创没有反应，但经过 2 天的全身糖皮质激素治疗最终得到改善。 在目前的报告中，实验室和放射学研究显示没有潜在系统性疾病的迹象，例如癌症、炎症性肠病或自身免疫性疾病。 来自病变的活检样本显示密集的中性粒细胞浸润，组织培养阴性。 诊断结果是什么？

A. Cutaneous leishmaniasis皮肤利什曼病

B. Cutaneous polyarteritis nodosa皮肤结节性多动脉炎

C. Cutaneous tuberculosis皮肤结核

D. Ecthyma gangrenosum坏疽性臁疮

E. Pyoderma gangrenosum坏疽性脓皮病

答案解析：

这些病变的典型外观是界限分明的皮肤溃疡，底部有红斑和紫色边缘。 在使用逐渐减量的糖皮质激素治疗 8 个月后，病变完全消退。

正确答案：E