角化棘皮瘤样倒置性毛囊角化病一例  

Keratoacanthoma-like inverted folliclar keratosis:a case

作　　者：谢宜彤 王文岭[1] 张歆 杨蓉娅 XIE Yi-tong;WANG WEN-ling;ZHANG Xin(Department of Dermatology,the Seventh Medical Center of Chinese PLA Geneal Hospital,Beijing 100700,China)

机构地区：[1]解放军总医院第七医学中心皮肤科,北京100700

出　　处：《实用皮肤病学杂志》2022年第5期310-312,共3页Journal of Practical Dermatology

摘　　要：31岁男性患者,左上肢丘疹1年余。皮肤科情况:左上肢见一直径5mm大小黑褐色半球状隆起性丘疹,界限清楚,结节中央有孔样开口并充以角质,质中等、无压痛,基底部无浸润感。皮损组织病理:肿瘤呈外生向外向内生长,底端钝平,肿瘤中央可见均质化红染角化物,周边表皮棘细胞增生呈漩涡状,棘细胞胞质淡染,向外毛根鞘分化;肿瘤周边细胞呈基底细胞样,未见细胞异形性和核丝分裂,周边相邻表皮呈衣领样包裹。皮肤镜:皮损区呈黑褐色背景,表面角化增生呈火山口样,基底见无结构红色区域。高频超声:表皮角化增生,真皮见较规则中低回声团,内部可见扩张毛细血管。诊断:角化棘皮瘤样倒置性毛囊角化病。手术切除,随访2年无复发。A 31-year-old male patient presented with papules on his left upper extremity for more than 1 year.Dermatological condition:there was a dark-brown hemispherical papule of about 5 mmx5 mm in size with clear boundaries on the left upper extremity.There was a perforated opening in the center of the tubercle and it was filled with keratin.It was medium in quality without tenderness,and there was no infiltration at the base.Histopathology:The tumor grows outward and inward,and the bottom of tumor was blunt and flat.Homogeneous keratinoid can be seen in the center of the tumor,the peripheral epidermal acanthocytes are proliferated and concave inward to form a vortex.The cytoplasm of the acanthocytes is lightly stained and differentiated into the outer hair root sheath.The peripheral cells were basal cell-like,and no cell atypia and mitosis were found.The surrounding epidermis was wrapped in a collar-like structure.Dermatoscopy:under the microscope,the skin lesions showed a dark brown background with keratinized surface,and the base of the lesion was a red area without structure.High-frequency ultrasound:The epidermis was hyperkeratotic.And the dermis had a regular round medium low echo mass with dilated capillaries.Diagnosis:Keratoacanthoma-like inverted folliclar keratosis.Surgical excision was performed,and there was no recurrenceaftera2-yearfollow-up.

关 键 词：毛囊角化病 倒置性 角化棘皮瘤样 

分 类 号：R758.69[医药卫生—皮肤病学与性病学]