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患者女,43岁。主诉:右枕后结节20年余,渐增大。现病史:患者20多年前右枕后无明显诱因出现一小米粒大、肤色丘疹,无自觉症状,多年来未予诊治,皮疹渐增大呈蘑菇状,表面较平滑,偶有黏稠伴异味分泌物排出。既往史:既往体健,家族成员中无类似疾病患者。体格检查:一般情况好,各系统检查无异常。实验室及辅助检查:血、尿常规和肝、肾功能均正常。皮肤科检查:右枕后见一枚蚕豆大、带细蒂结节,质地中等,表面较平滑,无红肿、破溃、血痂,可见小凹陷和毛发贯穿(图1),挤压无分泌物排出,周围无红肿、浸润。皮损组织病理学检查:真皮内较多的毛囊皮脂腺囊性结构,皮脂腺小叶大量增生呈放射状排列,毛囊漏斗部扩大、畸形,毛囊周
Female patient, 43 years old. Chief complaint: nodules after the right pillow more than 20 years, increasing. Current history: The patient more than 20 years ago, there is no obvious incentive after the right pillow a small grain of rice, skin color pimples, no symptoms, no diagnosis and treatment over the years, the rash gradually increased mushroom-like, the surface is relatively smooth, occasionally viscous with odor secretion Excretion. Past history: Past physical health, family members no similar diseases. Physical examination: the general situation is good, the system check no abnormalities. Laboratory and laboratory tests: blood, urine and liver and kidney function are normal. Dermatology examination: see the right occipital lobule after a large, with fine pedunculated nodules, medium texture, the surface is smooth, no swelling, ulceration, blood scab, visible small depression and hair penetration (Figure 1), squeeze no secretion Excretion, no swelling around, infiltration. Histopathological examination of skin lesions: more dermal follicles sebaceous cystic structure, sebaceous follicles lobular hyperplasia radial arrangement, follicular infundibulum expansion, deformity, hair follicle weeks