面部寻常狼疮继发鳞状细胞癌1例

A Case of Squamous Cell Carcinoma Arising from Lupus Vulgaris

患者女,45岁,农民。面部皮损20年,鼻部缺损6年,上唇增生性肿块1年。皮肤科情况:额面部、耳部、颈部可见广泛浸润性红褐色斑块或斑片,伴鳞屑;双下睑外翻;鼻梁塌陷萎缩,鼻软骨、鼻翼及鼻中隔缺损,仅见鼻孔;上唇中部见一3.0cm×2.0cm暗红色肉芽增生性肿块,界清,表面有糜烂和血痂,触之易出血。面部皮损和上唇部皮损组织病诊断:寻常狼疮(面部)继发鳞状细胞癌(上唇部)。抗结核治疗后,寻常狼疮皮损明显好转,患者因经济原因对鳞状细胞癌未进行治疗。

A 45-year-old female farmer presented with slowly growing multiple plaques over the forehead ,face and pinna for 20 years, a destructive nose for 5 years and hyperplasia bump on her upper lip for 1 year. Physiologi- cal examination revealed reddish brown scaly plaques on her face, ears and neck, ectropion of lower eyelid, the nasal bridge collapse and atrophy, nasal cartilage, nasal ala and septum defect with intact nares. There was a well defined, dark reddish granulomatous hyperplasia with erosion and blood crust on the middle of upper lip. The diagnoses of lupus vulgaris （face） and squamous cell carcinoma arising from lupus vulgaris （lip） were confirmed by biopsies from her face and upper lip. The facial lupus vuglaris was improved following standard antibercular therapy（ATY） within 3 months. The patient gave up the treatment of squamous cell carcinoma for economic reasons.