摘要
患者女,54岁,面颈部、躯干、四肢出现丘疹、斑块30余年,加重1年。皮肤科情况:全身见疣状黄褐色丘疹和斑块,表面污秽色结痂,对称分布。掌跖角化过度,指(趾)甲上有纵向条纹及甲缘V形缺口。皮损组织病理示:局灶性基底细胞层上裂隙,棘层上部表皮松解,可见谷粒和圆体细胞。诊断毛囊角化病,给予阿维A及对症处理,经过3周治疗后患者全身皮损明显好转。背部疣状斑块消退后暴露出一个较大的溃疡性肿块,4.6 cm×2.4 cm大小,边缘隆起,取溃疡组织病理检查示:溃疡的表皮表现为毛囊角化病的典型角化不良改变,溃疡区域由基底样细胞形成巢状肿瘤团块,有收缩间隙,组织学结果为毛囊角化病并发基底细胞癌。
A 54-year-old female presented with papules and plaques on her face, neck,trunk and limbs for more than 30 years.Her symptoms had aggravated for 1 year. Dermatological examination revealed warty yellowish brown papules and plaques involving the whole body.The surface had a dirty-colored crust, and the skin lesions were symmetrically distributed. The patient also had palmoplantar hyperkeratosis with longitudinal stripes and V-shaped defects in the finger(toe)nails.Biopsy of the lesion showed focal suprabasal cleavage of the epidermis containing acantholytic cells, corps ronds and grain cells. The diagnosis was Darier's disease. The patient was treated with Acitretin and symptomatic management. After 3 weeks of treatment the patient's systemic skin lesions improved significantly. However, after the wart-like plaque had subsided, there was a large ulcerated tumor4.6 cm×2.4 cm with elevated borders on the patient's back. The histopathologic examination of the tumor revealed that the epithelium of the wall of the ulcer showed dyskeratotic changes typical of Darier's disease and the ulcerated tumor comprised ‘basaloid' epithelial cells, forming nests with peripheral palisading.The histologic conclusion was that the lesion was Darier's disease with concurrent basal cell carcinoma.
作者
刘样满
王国安
张海璐
张鑫
LIU Yangman;WANG Guoan;ZHANG Hailu;ZHANG Xin(Department of Dermatology,the Second People's Hospital of Pingdingshan,Pingdingshan 467000,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2023年第11期1304-1307,1313,共5页
The Chinese Journal of Dermatovenereology
关键词
毛囊角化病
基底细胞癌
Darier's disease
Basal cell carcinoma
