恶性黑棘皮病并发Leser-Trélat征

Malignant acanthosis nigricans with Leser-Trélat sign:a case report

报告1例恶性黑棘皮病并发Leser-Trélat征。患者男,69岁。全身褶皱部位皮肤色素沉着、乳头瘤样增生,伴瘙痒半年。皮肤科检查:颜面部、双侧腹股沟、腋窝、肛周皮肤色素沉着,呈绒毛状或乳头瘤样增生;双眼睑缘和唇红区及颊黏膜乳头瘤样增生。双侧乳头和乳晕角化及色素沉着,颈部、上胸部、腹部及四肢可见米粒至黄豆大疣状角化性丘疹。胃镜检查及胃黏膜组织病理检查示贲门-胃底低分化腺癌。诊断:恶性黑棘皮病并发Leser-Trélat征。

A case of malignant acanthosis nigricans with Leser-Trélat sign is reported. A 69-year-old male patient presented with diffuse brownish darkening and papillomatous hyperplasia on the intertriginous regions over his body with itching for half a year. Physical examination showed the skin of the face, bilateral inguinal areas, axillae, and perianal region darkened, with villous or papillomatous hyperplasia. There were also papillomatous hyperplasia of his palpebral margin, vermilion, and buccal mucousa. The nipples and areolae were keratotic and brownish black in color. There were many keratotic verruciform papules on his neck, upper chest and abdomen, in sizes of grain or soybean. Gastroscopy revealed poorly differentiated adenocarcinoma of the gastric cardia and the bottom part of the stomach. Histopathological examination of the specimens from his skin lesion confirmed the diagnosis of acanthosis nigricans. The case was finally diagnosed as malignant acanthosis nigri cans with Leser-Trélat sign.