CO_2激光联合5-氨基酮戊酸光动力治疗手指鲍温病1例

A Case of Finger Bowen's Disease Cured by CO_2 Laser Therapy Followed with Aminolevulinic Acid Photodynamic Therapy

患者男,60岁。右食指近端桡侧不规则污褐色丘疹、斑块、结节1年余,加重2个月。皮损组织病理示:表皮全层细胞排列紊乱,可见不典型角质形成细胞,有明显异型性及角化不良细胞,真皮浅层可见大量淋巴细胞及慢性炎性细胞浸润。诊断:鲍温病。经CO2激光祛除皮损疣状斑块结节,炭化至肿块基底部上方,即行20%5-氨基酮戊酸(ALA)光动力疗法(PDT)治疗,共治疗4次。皮损完全恢复,随访20个月,未见新的皮疹发生。

A 60-year-old male presented with anomalous dark brown papula, plaque and tubercle are observed on the right index finger for more than 1 year and deteriorate in the last 2 months. Skin biopsy revealed that epider- mal cells are disorder, atypical keratinocytes exist, apparently atypical ceils and dyskeratotic cells can be ob- served, lymphocyte and chronic inflammatory ceils infiltration are found in the superficial layer of dermis. Di- agnosis：Bowen＇s disease. He was treated by removing surface verrucous plaque and carbonized till the fundus by CO2 laser therapy, then operating photodynanaic therapy （PDT） with 20% of 5-aminolevulinic acid （ALA） for 4 times. Result： papula, plaque and tubercle disappeared completed and no newborn skin rash was observed after 20 months follow-up.