多发性巨大子宫肌瘤伴获得性反应性穿通性胶原病1例

Acquired Reactive Perforating Collagenosis Complicated with Multiple Giant Uterine Fibroids: A Case Report

摘要: 本文报道一例47岁女性患者，躯干及四肢出现伴瘙痒的角化性丘疹、结节3月余。结合皮肤镜特征及组织病理学检查(表皮火山口样结构、胶原纤维穿通现象及Masson染色显示退行性胶原束垂直移行)，确诊为获得性反应性穿通性胶原病(ARPC)。患者住院期间发现多发性巨大子宫肌瘤(最大约10.5 × 8.1 × 8.5 cm)，组织病理学显示子宫肌瘤伴黏液变性，行子宫全切术后皮损迅速消退，随访20个月无复发。从本案例中推测ARPC与子宫肌瘤可能存在潜在关联，虽然目前并没有明确的通路机制研究，但本文作为首次报道ARPC与子宫肌瘤的潜在可能的文章，为临床诊疗及机制研究提供新方向。

Abstract: This article reports a case of a 47-year-old female patient who presented with pruritic keratotic papules and nodules on the trunk and extremities for over three months. Based on characteristic dermoscopic features and histopathological examination, revealing epidermal crater-like architecture, transepidermal elimination of collagen bundles, and vertically oriented degenerated collagen bundles demonstrated by Masson staining, a diagnosis of Acquired Reactive Perforating Collagenosis (ARPC) was confirmed. During hospitalization, multiple giant uterine leiomyomas (largest approximately 10.5 × 8.1 × 8.5 cm) were discovered. Histopathology of the uterine lesions showed leiomyomas with myxoid degeneration. The skin lesions rapidly resolved following total hysterectomy. The patient remained recurrence-free during a 20-month follow-up period. This case suggests a potential association between ARPC and uterine leiomyoma. Although no definitive pathogenic pathways have been established, this report, as the first documented case suggesting this potential link, offers new perspectives for clinical management and mechanistic investigations.