皮脂腺痣126例临床病理分析

Clinical Pathological Analysis of 126 Cases With Nevus Sebaceous

目的探讨皮脂腺痣不同年龄阶段的临床表现、组织病理学特点及肿瘤发生率。方法收集126例皮脂腺痣患者,按年龄分成三组进行回顾性分析。结果婴儿儿童期(<10岁)10例,皮损单发,好发于头皮和面部,略高出皮面,表面光滑无毛发,病理为表皮轻度肥厚,真皮皮脂腺发育不全,并有少量幼稚毛囊;青春发育期(10～20岁)80例,76例单发,4例多发,皮损明显隆起,疣状,黄色,病理为表皮角化过度,棘层肥厚呈乳头瘤样增生,真皮不同程度的皮脂腺增生,部分病例可见幼稚毛囊和/或异位大汗腺;成人期(>20岁)36例,有3例多发,临床与病理表现同青春发育期。在总共126例患者中有幼稚毛囊者65例(51.59%),异位大汗腺36例(28.57%),有7例(5.56%)并发肿瘤,其中2例(1.59%)为基底细胞上皮瘤。结论①婴儿儿童期的临床表现和病理形态与青春发育期及成人期不同。②皮脂腺痣并发肿瘤的概率为5.56%,远低于传统10%～40%的认识。

Objective To discuss the clinical manifestation, the histopathologic characteristic and the incidence of tumor of nevus sebaceous in different age grades. Methods Collected 126 nevus sebaceous patients, and then divided them into three groups according to the age to make the retrospective analysis. Results Patients of the infant child time （〈10 years old） are 10 cases, the skin lesion is single and smooth, commonly involves the scalp and face, slightly outdoes the surface, the pathological feature is mildly pachynsis for the epidermis, hypoplasia for the dermis sebaceous glands, and existence for the few weak hair follicles. The patients of the youth development period （10-20 years old） are 80 cases, 76 cases among them are single, and the other 4 cases are much more than one. The skin damages are wart shape and yellow, obviously stick out, and the pathological feature is hyperkeratosis for the epidermis, acanthosis, papillomatous proliferation and varying degree sebaceous glands proliferation for the dermis, partial cases are existent of weak hair follicles and/or allotopic big sweat glands. The patients of the adult period （〉20 years old） are 36 cases, 3 casles among them are not single, all the cases display the same clinical manifestation and histopathologic characteristic as the youth development period. 65 cases of all the 126 patients have the weak hair follicles （51.59%）, 36 cases have the allotopic big sweat glands （28.57%）, 7 cases （5.56%） have the secondary tumor, and 2 cases （1.59%） have the basal cell epithelioma. Conclusion ①The clinical manifestation and the histopathologic characteristic of the infant child time are different from the youth development period and the adult period. ②The incidence of tumor of nevus sebaceous is 5.56%, much lower than the traditional understanding of 10%-40%.