甲下鳞状细胞癌误诊为甲下血管球瘤1例  

A Case of Subungual Squamous Cell Carcinoma Misdiagnosed as Glomus Tumour

作　　者：刘柳宏 郑秀芬 何仁亮 薛汝增 杨磊[3] 郑雯 LIU Liuhong;ZHENG Xiufen;HE Renliang;XUE Ruzeng;YANG Lei;ZHENG Wen(Dermatology Hospital of Southern Medical University,Guangzhou 510091,China;Shunde Hospital of Southern Medical University,Shunde 528300,China;Nanfang Hospital of Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学皮肤病医院,广东广州510091 [2]南方医科大学顺德医院,广东顺德528300 [3]南方医科大学南方医院,广东广州510515

出　　处：《中国皮肤性病学杂志》2022年第8期956-958,共3页The Chinese Journal of Dermatovenereology

摘　　要：患者女,62岁,右拇指红斑、疼痛2年。皮肤科情况:指甲由中段至远端有一红色的纵裂、畸形,伴远端甲板溶解,无溃疡或渗出,无结痂、疣状外观和局限性角化过度;有压痛,活动无受限。冷敏感试验(+)、Love试验(+)、Hildreth征(+);典型的临床三联征:局部压痛、剧烈疼痛和冷敏感,Love试验(+),高度提示是甲下血管球瘤。术前皮肤镜显示背景呈粉红色,有裂片状出血,直径约为3 mm。手术切除病理提示:大小不一的鳞状上皮团块,少量细胞异型,侵犯真皮。诊断:甲下鳞状细胞癌。A 62-year-old female presented 2-year history of an erythema on her right thumb with pain.Dermatological examination showed a longitudinal fissure and deformity of the nail from the medial area to the distal margin,with dissolution of the distal deck.There were no ulceration,exudation,scab,warty appearance or localized hyperkeratosis.The lesion was pressing pain without limitation of movement.The cold sensitivity test,Love's pin test and Hildreth's sign were positive.Therefore,the typical clinical trial of localized tenderness,severe pain,and cold sensitivity,with Love's pin test(+),was highly suggestive of a subungual glomus tumour.Preoperative dermoscopy showed pink coloration of the background with splinter haemorrhages,measuring 3 mm in diameter.To our surprise,the histopathological examination revealed a mass of squamous cells varying size,with a few atypia cells invading the dermis.The diagnosis of subungual squamous cell carcinoma was made.

关 键 词：皮肤镜 血管球瘤 甲下鳞状细胞癌 

分 类 号：R751[医药卫生—皮肤病学与性病学] R739.5[医药卫生—临床医学]