脂溢性角化病148例临床与组织病理分析  

Clinical and pathological analysis of 148 cases with seborrheic keratosis

作　　者：刘波[1] 李晓静 LIU Bo;LI Xiao—jing(Department of Dermatology,Shanghai Fifth People's Hospital,Fudan University,Shanghai 200240,China)

机构地区：[1]复旦大学附属上海市第五人民医院皮肤科,上海200240 [2]复旦大学附属上海市第五人民医院病理科,上海200240

出　　处：《临床皮肤科杂志》2021年第6期335-337,共3页Journal of Clinical Dermatology

摘　　要：目的:探讨脂溢性角化病的临床特点及组织病理特征。方法:回顾性分析148例脂溢性角化病患者的临床表现及组织病理特征。结果:①男女患病比例为1:1.08,发病年龄23~89岁,病程2个月~30年;②头、面部为好发部位,51~70岁患者最为多见;③皮损单发性37例,皮损多发性111例,皮损直径1~30mm,大多表现为圆形或类圆形境界清楚的黑褐色或黑色疣状扁平丘疹;④148例患者中临床诊断为脂溢性角化病者93例,临床和组织病理诊断符合率为62.8%;⑤148例中棘层肥厚型63例(42.6%)、角化过度型40例(27.0%)、棘层肥厚和角化过度混合型19例(12.8%)、腺样型13例(8.8%)、刺激型9例(6.1%)、菌落型2例(1.4%)黑素棘皮瘤型1例(0.7%)及角化过度型和腺样型混合1例。结论:结合病史,脂溢性角化病在临床上诊断并不是很难,但应与某些疾病相鉴别,其组织病理有显著特征。Objective: To investigate the clinical and pathological characteristics of seborrheic keratosis. Methods: The clinical manifestations and histopathological characteristics of 148 patients with seborrheic keratosis were retrospectively analyzed.Results:(1) The ratio of male to female patients was 1∶1.08(disease duration range: 2 months to 30 years;age range: 23 to89 years old).(2) Seborrheic keratosis was commonly found on the face of older people aged 51 to 70 years old.(3) Single lesion was found in 37 cases, and multiple lesions were found in 111 cases. The diameter of skin lesion ranged from 1 to 30 mm,manifesting as clear round or round-like dark or black verrucous flat papules.(4) Ninety-three cases were identified, showing a 62.8% concordance between clinical and pathological diagnosis.(5) Among the 148 cases, 63 cases(42.6%) were presented with acanthosis, 40(27.0%) with hyperkeratosis, 19(12.8%) with a mixture of acanthosis and hyperkeratosis, 13(8.8%) with adenoid, 9(6.1%) with irritation, 2(1.4%) with colony, 1(0.7%) with melanoacanthoma and 1 with a mixture of hyperkeratosis and adenoid. Conclusion: Seborrheic keratosis can be diagnosed based on the patient’s medical history, and should be distinguished with some other diseases based on distinctive histopathological features.

关 键 词：脂溢性角化病 临床特点 组织病理 

分 类 号：R739.5[医药卫生—肿瘤]