Granulomatous Pigmented Purpuric Dermatosis in a Patient with (Inactive) Myasthenia Gravis: A Case Report and Review of the Literature.

IF 0.9 Q4 DERMATOLOGY
Case Reports in Dermatology Pub Date : 2023-05-25 eCollection Date: 2023-01-01 DOI:10.1159/000530034
Apirada Dhekariyapak, Penpun Wattanakrai
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Abstract

Granulomatous pigmented purpuric dermatosis (GPPD) is a rare histologic variant of pigmented purpuric dermatosis (PPD) characterized by dermal histiocyte-rich interstitial infiltration with or without granuloma formation in addition to the other typical features of PPD. GPPD was previously observed more frequently to affect Asians and was reported to be associated with dyslipidemia. However, our literature search of 45 documented GPPD cases revealed an increasing prevalence in Caucasians in addition to dyslipidemia and associated autoimmune diseases. To date, etiopathogenesis of GPPD is unknown but may involve dyslipidemia, genetic and immunological factors such as autoimmune dysregulation or a sarcoidal reaction associated with C. acnes. GPPD is usually persistent and recalcitrant to treatments. We report a case of GPPD in a 57-year-old Thai woman with underlying myasthenia gravis who presented with a pruritic eruption on both lower legs. After treatment with 0.05% clobetasol propionate cream and oral colchicine, the lesion improved with marked flattening and disappeared with residual postinflammatory hyperpigmentation. We provide a literature review of the epidemiology, etiopathogenesis, concomitant comorbidities, clinical symptoms, dermatoscopic features, and treatments of GPPD.

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肉芽肿性色素紫癜性皮肤病合并(非活动性)重症肌无力1例报告及文献复习。
肉芽肿性色素性紫癜性皮肤病(GPPD)是一种罕见的色素性紫癜性皮肤病(PPD)的组织学变异,除PPD的其他典型特征外,其特征是真皮组织细胞丰富的间质浸润,伴或不伴肉芽肿形成。以前观察到GPPD更常影响亚洲人,据报道与血脂异常有关。然而,我们对45例GPPD病例的文献检索显示,除了血脂异常和相关自身免疫性疾病外,白种人的GPPD患病率也在增加。迄今为止,GPPD的发病机制尚不清楚,但可能涉及血脂异常、遗传和免疫因素,如自身免疫失调或与痤疮C.相关的结节状反应。GPPD通常对治疗具有持续性和难治性。我们报告一例GPPD在一个57岁的泰国妇女与潜在的重症肌无力谁提出了瘙痒性爆发在两个小腿。经0.05%丙酸氯倍他索乳膏联合口服秋水仙碱治疗后,病变明显变平,消失,炎性后色素沉着残留。我们对GPPD的流行病学、发病机制、伴随合并症、临床症状、皮肤镜特征和治疗方法进行了文献综述。
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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
57
审稿时长
9 weeks
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