多发性边缘离心性角化棘皮瘤一例  

Multiple keratoacanthoma centrifugum marginatum： first case report in China

作　　者：李建国[1] 李振鲁[1] 朱钵[1] 孙廷谊[2] 王国芳[1] 

机构地区：[1]河南省人民医院皮肤科,郑州450003 [2]河南省人民医院病理科,郑州450003

出　　处：《中华皮肤科杂志》2010年第9期599-601,共3页Chinese Journal of Dermatology

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.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.

关 键 词：角化棘皮瘤 病理学 临床 维甲酸 

分 类 号：R739.5[医药卫生—肿瘤]