光动力疗法成功治疗女童外阴鲍恩样丘疹病1例及文献复习  

Successful treatment of bowenoid papulosis with ALA-PDT therapy in a girl:a case report with literature review

作　　者：张斌[1] 伦文辉[2] 徐子刚[1] 伏利兵[3] 徐哲[1] 王珊[1] 马琳[1] 邢嬛[1] 

机构地区：[1]首都医科大学附属北京儿童医院皮肤性病科,北京100045 [2]首都医科大学附属北京地坛医院皮肤性病科,北京100015 [3]首都医科大学附属北京儿童医院病理科,北京100045

出　　处：《临床皮肤科杂志》2016年第1期60-63,共4页Journal of Clinical Dermatology

基　　金：北京市医药管理局临床医学发展专项经费(ZYLX201601)资助项目

摘　　要：患儿女,9岁。因外阴出现黑色丘疹1个月余,渐加重1周。患儿外阴散在或聚集分布黑色扁平丘疹,部分融合成斑块。外阴皮损组织病理检查显示,角化过度,棘层增厚和表皮突增宽,细胞结构紊乱,全层可见非典型细胞,但基膜完整。皮损免疫组化结果示人乳头瘤病毒(HPV)阳性。PCR-反向点杂交法检测结果 HPV-16(高危型)阳性。依据临床及实验室检查确诊为由HPV-16感染引起的鲍恩样丘疹病。给予5-氨基酮戊酸(ALA)光动力疗法(PDT)治疗3次,外阴皮损全部消退。之后外用咪喹莫特软膏维持治疗3个月,随访6个月无复发。ALA-PDT是治疗儿童鲍恩样丘疹病的一种安全、有效、无明显痛苦和不良反应的新疗法。A 9-year--old girl presented with black papules on the vulva for 1 month, with gradual aggravation for 1 week. Physical examination showed scattered and clustered, flat black papules on the vulva. Histopathologic examination revealed hyperkeratosis, acanthosis, widening of the rete ridges, disorganized cellular structure and atypical keratinocytes with intact basement membrane. Immunohistochemieal staining showed positive for Human Papillomavirus （HPV）. MR reverse dot blot showed HPV type 16 positive. According to clinical features and laborato~ findings, a diagnosis of bowenoid papulosis was made, After 3 treatments with 5-aminolevuhnic acid-photodynamic therapy （ALA-PDT）, the vulvar lesions completely disappeared. Topical imiquimod cream was used for maintenance treatment for 3 months. The patient has been followed up for 12 months without recurrence. ALA-PDT is a safe and effective therapy for bowenoid papulosis in children.

关 键 词：鲍恩样丘疹病 5-氨基酮戊酸 光动力治疗 人乳头瘤病毒 儿童 

分 类 号：R739.5[医药卫生—肿瘤]