增殖性红斑的治疗现状及进展  

Treatment of erythroplasia of Queyrat： current status and advances

作　　者：冯广东[1] 王焱[1] 方方[1] 

机构地区：[1]中国医学科学院北京协和医学院皮肤病研究所、江苏省皮肤病与性病分子生物学重点实验室,南京210042

出　　处：《国际皮肤性病学杂志》2015年第5期294-297,共4页International Journal of Dermatology and Venereology

基　　金：江苏省临床医学科技专项（BL2012003）,2013年江苏省皮肤病与性病分子生物学重点实验室培育课题

摘　　要：增殖性红斑是累及龟头及包皮黏膜的Bowen病,为一种表皮内原位癌.本病主要发生于中年以上无包皮环切史的男性患者,进展为鳞状细胞癌的可能性约33％.有效治疗方法包括局部手术切除、Mohs手术、阴茎部分或全部切除术、局部外用5％氟脲嘧啶软膏或5％咪喹莫特乳膏、冷冻、放疗、激光、光动力治疗等.传统外用药物治疗,操作简单,患者容易接受,但复发率高.近年来,光动力及激光疗法发展迅速,逐渐成为该病的一线治疗方案.但手术治疗仍为金标准,且复发率最低,龟头包皮病变切除后复发率低于2％,但同时会引起阴茎的外观及功能障碍.不同治疗方案的选择取决于患者的免疫状况、病变部位以及患者的意愿.Erythroplasia of Queyrat （EQ）,an in situ intraepidermal squamous cell carcinoma,is considered as Bowen＇s disease of the glans and prepuce.EQ is seen almost exclusively in uncircumcised middle-aged or older men,and may progress into invasive squamous cell carcinoma in about 33% of patients.Effective treatments include local excision,Mohs surgery,partial or total penectomy,topical 5-fluorouracil 5% ointment or imiquimod 5% cream,cryotherapy,radiotherapy,laser therapy,photodynamic therapy,and so on.Traditional topical treatment is simple to operate and easily accepted by patients,but recurrence is frequent.Recently,photodynamic therapy and laser therapy have developed rapidly and become the first-line therapy of EQ.However,surgical treatment is still considered the golden standard therapy for EQ with reduced recurrence.The recurrence rate is lower than 2% in patients with EQ of the glans and prepuce after removal of lesions,but the appearance and function of the penis are usually affected by surgical operation.The selection of treatment approaches depends on the immune status of,lesional sites in and will of patients.

关 键 词：增殖性红斑 肿瘤 鳞状细胞 外科手术 外用药 临床方案 

分 类 号：R737.27[医药卫生—肿瘤]