- 期刊
Collagenous and Elastotic Marginal Plaques of the Hands-A Case Report
手部膠原與彈力纖維板塊－病例報告
摘要
手部膠原性與彈力纖維板塊是一種罕見後天性皮膚真皮結締組織的異常，病程緩慢，且沒有明顯的臨床症狀。我們提出一位72歲的男性病人在左右手掌心與掌背的交界處，產生無症狀性對稱性的直線狀硬皮變化的斑塊。病灶的進展是由大拇指的外側往食指的內側進行，病灶的產生約有2-3年。職業是農夫，家族其它的成員並沒有相同的症狀。皮膚切片下可見沒有細胞組成的區域在真皮層，增厚的膠原蛋白凌亂地排列，有些膠原蛋白的排列會與表皮走向垂直，夾雜有嗜鹼性的鈣質沈積與退化的彈力纖維。經由臨床症狀與組織切片，診斷為手部膠原與彈力纖維板塊。陽光傷害與慢性重複性壓力摩擦是形成手部膠原與彈力纖維板塊的可能致病機轉。透過尿素與水楊酸的局部治療，並建議病人防曬與穿戴手套，發現皮膚的症狀並沒有持續進行或是手指的靈活度有受影響。
關鍵字
無資料並列摘要
Collagenous and elastotic marginal plaques of the hands is a rare acquired slowly progressive and asymptomatic dermal connective tissue abnormality. Herein, we present a 72-yearoldman with a 2-3 year history of asymptomatic symmetrical sclerotic linear plaques extending along the junction of the dorsal and palmar skin of the hands from the lateral aspect of the thumb to the medial aspect of the index finger. He was a farmer. No other family members had similar symptoms. A skin biopsy showed a dermal acellular zone composed of thickened bundles of collagen haphazardly arranged, some perpendicular to the epidermis, admixed with elastic fibers and amorphous basophilic elastotic materials. Granular calcium deposits were identified, particularly within degenerated collagen bundles. According to the clinical and histological features, collagenous and elastotic marginal plaques of the hands was diagnosed. Actinic degeneration and chronic repetitive pressure have been implicated in its pathogenesis, and our patient reported marked actinic exposure with chronic occupational friction. Topical treatment with urea and salicylic acid was applied, and avoiding sunlight and wearing glove were also advised. No progression about skin lesions or limitation about hand ambidexterity was mentioned after treatment.