摘要
目的探讨光线性角化病的临床及组织病理学特点,减少其误诊率和漏诊率。方法对76例经过活检确诊为光线性角化病患者的临床资料进行回顾性分析。结果 76例患者中,平均年龄(75.22±11.37)岁;平均病程(3.53±6.25)年;男∶女发病比例为1∶1.24;皮损发生于面部的患者最多(73例,96.05%);临床表现:淡红色斑片10例(13.16%),淡褐色斑片3例(3.95%),角化性丘疹26例(34.21%),角化性斑块32例(42.11%),溃疡2例(2.63%),皮角3例(3.95%);组织病理分型:肥厚型25例(32.89%),萎缩型17例(22.37%),棘层松解型8例(10.53%),色素型4例(5.26%),苔藓样型和鲍恩样型各11例(14.47%)。其中4例(5.26%)发展为侵袭性鳞癌。76例的真皮浅层均可见明显日光弹性纤维变性,并可见不同程度的以淋巴细胞为主的浸润。结论光线性角化病好发于老年人的曝光部位,以面部多见,临床表现多样,病理亚型以肥厚型和萎缩型多见,可发展为侵袭性鳞癌,需要临床医生重视。
Objective To study the clinical and histopathological features of actinic keratosis in order to reduce the misdiagnosis rate and missed diagnosis rate. Methods The clinical data of 76 cases of actinic keratosis diagnosed by biopsy were analyzed retrospectively. Results The mean age was (75.22 ± 11.37 ) years. The mean course was(3.53 ±6.25 )years. The ratio of male/female was 1 : 1.24. The most frequently affected area was face (73 cases, 96. 05% ). The lesions were reddish macules (13. 16% ), brownish macules ( 3.95% ), keratotic papules ( 34.21% ), keratotic plaques ( 42.11% ) , cutaneous horns ( 3.95% ) and ulcers(2.63% ). Histopathological changes included hypertrophy(32.89% ), atrophy(22.37% ), acantholysis( 10.53% ) , pigmentation (5.26%) , lichenoid change ( 14.47% ) and bowenoid change ( 14.47% ). Four cases(5.26% ) developed to invasive SCC. All the cases showed solar elastosis and lymphocyte infiltration in dermis. Conclusion AK develops mostly on sun-exposed areas, especially face, in the old people with various presentations. The main histologic features are hypertrophy type and atrophy. AK can develop to invasive SCC and should be paid more attention.
出处
《中国皮肤性病学杂志》
CAS
北大核心
2013年第10期1023-1025,共3页
The Chinese Journal of Dermatovenereology
关键词
角化病
光线性
Keratosis, actinic