阿维A联合手术治疗多发性Bowen病并发鳞状细胞癌一例  

Oral acitretin combined with surgical excision for the treatment of multiple Bowen＇s disease and squamous cell carcinoma： a case report

作　　者：李圆圆[1] 张本利[1] 冯波 宋亚丽[1] 张莉[1] 

机构地区：[1]山东大学附属省立医院皮肤科,济南250021 [2]山东省禹城市人民医院皮肤科

出　　处：《国际皮肤性病学杂志》2012年第2期69-71,共3页International Journal of Dermatology and Venereology

基　　金：基金项目：山东省自然科学基金青年基金（ZR2011HQ056）

摘　　要：报道1例多发性Bowen病并发鳞癌。患者男，61岁，全身出现多处红褐色斑块13年。患者既往养鸡多年，双上肢经常被划伤或啄伤，部分皮疹发病前有明确的外伤史。患者体质较弱，患有多种系统性疾病，间断服药治疗。皮肤科检查：全身见40余处大小不等红褐色斑片及斑块，最小约黄豆大小，最大位于右侧锁骨区，约10cm×4cm，表面粗糙，覆油腻性痂皮，边界清楚，部分形状不规则。右手拇指背见一处约2cm×2cm大小肿物，表面有黄白色痂皮，呈砺壳状，质硬。右手拇指背肿物全切，组织病理检查：高分化鳞状细胞癌。左侧胸部红褐色斑块活检，组织病理检查为：Bowen病。我们将鳞状细胞癌皮损手术切除后植皮，余皮疹给予阿维A口服治疗，所有皮疹均明显好转，部分完全消退。A case of multiple Bowen＇s disease and squamous cell carcinoma is reported. A 61-year-old man presented with multiple brunneus plaques all over the body for 13 years. He was often scratched or pecked in the upper limbs during the feeding of chickens and some lesions developed with a definite history of injury. The patient suffered from several systemic diseases and took medicines intermittently. Dermatological examination revealed more than 40 brunneus patches and plaques, with the smallest lesions resembling soybeans and the largest lesions measuring 10 cm ×4 cm in size. All the lesions had a rough surface and greasy crust with a clear margin and irregular shape. There was an indurated oyster shell-like mass measuring 2 cm × 2 cm in size on the dorsum of the right thumb, with yellow-white crusts. The mass was completely resected and histopathological examination revealed a diagnosis of well differentiated squamous cell carcinoma. Histopathological examination of brunneus plaques on the left chest confirmed a diagnosis of Bowen＇s disease. The skin defect following resection of the squamous cell carcinoma was repaired by skin transplantation, and remaining lesions were managed with oral acitretin. Thereafter, all the lesions markedly improved and some lesions completely subsided.

关 键 词：BOWEN病 鳞状细胞癌 阿维A 

分 类 号：R739.5[医药卫生—肿瘤]