寻常性银屑病合并基底细胞癌、鳞状细胞癌及鲍恩病一例

A case of psoriasis vulgaris complicated with basal cell carcinoma,squamous cell carcinoma and bowen's disease

54岁男性患者,右下腹、阴阜、阴囊褐色肿物3年。皮肤科情况:右下腹可见2个直径1.5 cm大小褐色结节;阴阜部可见一3 cm×2 cm大小粉红色结节,其间可见1 cm×0.5 cm大小溃疡面,深度约0.2 cm;阴囊可见一2 cm×1 cm大小斑块。既往寻常性银屑病病史32年,背部基底细胞癌史7年。皮损组织病理:(右下腹部)表皮全层不典型角质形成细胞增生,增生表皮内散在坏死角质形成细胞、角化不良细胞,可见核分裂像;(阴阜部)表皮不典型角质形成细胞增生,突破基膜浸润生长至真皮中下部,全层细胞异型,排列紊乱,核分裂像易见。诊断:鳞状细胞癌(阴阜部)、鲍恩病(阴囊、右下腹部)。手术完整切除,随访6个月无复发。

A 54-year-old male patient had brown masses in the monspubis,scrotum and right lower abdomen for 3 years.Dermatology:2 brown nodules with diameter about 1.5 cm can be seen in the right abdomen;one about 3 cm×2 cm pink nodules can be seen in the monspubis,with about 1 cm×0.5 cm ulcer,depth about 0.2 cm;a plaque can be seen in the scrotum about 2 cm×1 cm.The previous of psoriasis vulgaris was 32 years,back basal cell carcinoma 7 years.Histopathology of the skin lesions:(right lower abdomen)atypical keratinocytes and dyskeratotic cells scattered in the hyperplastic epidermis,with mitotic phase visible;(monspubis)atypical keratinocyte hyperplasia in the epidermis,breaking through the basement membrane and infiltrating into the middle and lower part of the dermis,the whole layer of cells are heterotypic and disorderly arranged,mitosis is easy to see.Diagnosis:squamous cell carcinoma(monspubis),Bowen's disease(scrotum,right lower abdomen).Complete resection was performed and no recurrence was found after 6 months of follow-up.