麻风足与小腿溃疡癌变5例报道

Five cases report of canceration of Leprosy foot and leg ulcers

目的麻风足溃疡是麻风患者最常见的并发症。本文探讨麻风足溃疡癌变的发生率和相关因素及其早期临床表现、病理图像、诊断和不同治疗方法对预后的影响。方法对近来发现的5例溃疡癌变患者进行了观察、病史回顾、分析和治疗。结果麻风足与小腿溃疡发生癌变并非罕见，溃疡癌变多见于足底，但其它部位也可发生。癌变与溃疡长期炎症刺激有关，因此对任何部位、不易愈合的溃疡均应引起注意，对肉芽组织异常增生或呈菜花状，渗液、臭味加重的溃疡宜多次、多处活检以筛查是否癌变。临床上鳞癌最多见。确诊后截肢可获满意疗效。癌变的发展可向腹股沟淋巴结扩散，晚期向肺部转移，预后不良。结论对溃疡病人应加强自我护理，采取综合性治疗方法治愈溃疡并防止复发，临床上应对溃疡癌变保持高度警惕，争取早期发现与治疗。

Objective Foot ulcers are the most common complication in Leprosy patients. This article explores leprosy foot ulcers and the incidence of cancer-related factors and early clinical manifestations, pathology images, diagnosis and treatment of different prognosis. Methods The recent discovered five cases of cancer in patients with ulcers were observed and treated, the medical history were reviewed and analyzed. Results The canceration of leprosy foot and leg ulcers are not uncommon, cancer more common in footplate, but may also occur in other parts. Cancer and ulcers can cause long-term inflammation and therefore, the ulcers in any location should be paid enough attention. The biopsy should be carded out to monitor the canceration such as granulation tissue paraplasm, cauliflower-like, the aggravated of effusion and foul smell. Squamons cell carcinoma is the most common histological type. Promising curative effect could be acquired by amputation. The cancer could spread to the inguinal lymph nodes, and in advanced stage the cancer could transfer to the lungs, which indicate the poor prognosis. Conclusions Ulcer patients should strengthen self-care, a comprehensive treatment cure ulcers and prevent recurrence of cancerous ulcer should remain on high alert for early detection and treatment.