高龄老人脂溢性角化病的临床及病理特征分析

Clinical and Pathological Study of the Characteristics of Seborrheic keratosis in senility

目的探讨高龄老人(≥80岁)脂溢性角化病(SK)的临床特征、组织病理特征、误诊情况及治疗方法。方法对214例组织病理学诊断为高龄SK患者的临床特征、病理资料、误诊情况、治疗方法进行回顾性分析。结果临床特征:病程长,平均(32±8.6)年;头面部多发,达38.79%;皮损均为多发,皮疹色泽为褐色至黑色,81.31%有瘙痒不适,44.39%述突然变大并突起、色泽加深,24.77%有皮损反复表面破溃结痂。病理特征:主要是棘细胞型、色素型和角化过度型,分别占39.25%、24.30%和14.49%。误诊率高。结论高龄SK病史长,皮损多,面积大,颜色深,变化大,合并不适症状比例高。误诊原因与病程长、皮损变化大及病理类型和组织学变化有关。

Objective To analyze the clinical and histopathological charateristics,as well as the misdiagnosis status and the therapeutic methods of seborrheic keratosis in senility （≥ 80 years old）, in addition, to raise the awareness and to elevate the levels of diagnosis and treatment of the disease in senility in clinic situations. Methods The clinical and pathological features,the misdiagnosis status and the treatment methods were retrospectively analyzed in 214 cases of elderly patients with the disease. Results The clinical course was long,with an average of （32±8.6）years. Lesions were mostly seen on the head and face,reaching the proportion of 38.79%. Lesions were multiple in all of the patients. The colour of the tetters varies from brown to black. 81.31% of the patients complained of itching,and 44.39% of the patients complained of a sudden enlargement and deepenning of the eolour of the tetters. Recurrent surface ulceration and scab,as well as other skin impairment were found in 24.77% of the patients. The pathological findings showed that prickle cell type,pigmental type and hyperkeratosis type constituted 39.25% ,24.30% and 14.49% respectively. Misdiagnosis was common. Conclusions Seborrheic keratosis in senility is characterized by long course,large area and obvious skin lesions, deep-colored and frequently changed skin tettesr, and a high proportion of various discomfort. The causes of misdiagnosis are related to the long disease course,various presentation of skin impairment,different kinds of pathological and histological types of the disease, etc.