中华皮肤科杂志 ›› 2010, Vol. 43 ›› Issue (9): 599-601.

• 论著 •    下一篇

多发性边缘离心性角化棘皮瘤一例

李建国1,李振鲁2,朱钵2,孙廷谊3,王国芳3   

  1. 1. 河南省人民医院
    2. 郑州市河南省人民医院皮肤科
    3.
  • 收稿日期:2009-10-23 修回日期:2010-05-05 发布日期:2010-09-10
  • 通讯作者: 李建国 E-mail:drljg006@163.com

Multiple keratoacanthoma centrifugum marginatum: first case report in China

  • Received:2009-10-23 Revised:2010-05-05 Published:2010-09-10
  • Contact: Jian-Guo Li E-mail:drljg006@163.com

摘要:

报告国内首例多发性边缘离心性角化棘皮瘤(keratoacanthoma centrifugum marginatum)。患者女,37岁,以面部陆续出现丘疹和斑块4个月而就诊。皮肤科检查:患者面部散在数十个大小不等、边界清楚的淡红色或近肤色、火山口状丘疹及地图状斑块;丘疹中央呈脐凹状并有灰褐色角质状物;斑块边缘呈堤状隆起,内侧覆较厚褐色痂样角质物,中央部分消退;组织病理示:角化过度和角化不全,表皮呈条索状向真皮不规则延伸,可见鳞状涡和角囊肿样结构,肿瘤细胞胞质嗜酸性毛玻璃样,符合角化棘皮瘤特征;结合临床与病理诊断为多发性边缘离心性角化棘皮瘤。口服阿维A及外用维A酸治疗后痊愈,随访3年未复发。

关键词: 边缘离心型角化棘皮瘤, 组织病理

Abstract:

A case of multiple keratoacanthoma centrifugum marginatum is first reported in China. A 37- year-old woman was admitted to the hospital for papules and plaques on her face, which had been increasing in number for 4 months. Cutaneous examination revealed dozenes of well-marginated, pale-red or skin-colored crateriform papules of variant size, and plaques in a geographic pattern on her face. The papules presented with a central umbilication filled with grey-brown corneous material. The plaques were surrounded by dyke-like borders, covered with thick, crusted brown corneous material, and partly depressed in the center. Histopathology showed hyperkeratosis, parakeratosis, irregular strip-like extension of epidermis into dermis, keratinous cysts and squamous eddies. The tumor cells had eosinophilic and glassy cytoplasm characteristic of keratoacanthoma. Given both the clinical and histologic evidence, a diagnosis of multiple keratoacanthoma centrifugum marginatum was made. After more than 3 months of treatment with oral acitretin and topical tretinoin, the lesions faded, leaving rugosity scars. No relapse was noted during 3-year follow-up.

Key words: keratoacanthoma centrifugum marginatum, Histopathology