外阴臀部汗孔角化症误诊为湿疹1例

A Patient of Vulvar Buttock Genitogluteal Porokeratosis Misdiagnosed Eczema

患者男,63岁。臀部出现皮疹十余年。曾在多家医院诊断为"慢性湿疹",并予以治疗,疗效不佳。皮肤科情况:两侧臀部弥漫性灰褐色增生性斑块,皮损边缘隆起不明显;臀部四周及大腿部散在绿豆至黄豆大小的灰褐色角化性丘疹,边缘隆起,中央萎缩。皮损组织病理示:角化过度伴角化不全,部分区域见鸡眼样板状角化不全,其下方颗粒层消失,棘层内细胞排列不甚规则,有散在角化不良细胞,真皮浅层散在淋巴细胞为主的炎症浸润。结合临床表现和皮肤组织病理诊断:外阴臀部汗孔角化症。

A 63-year-old male patient presented with papules distributed over on his buttockships for over ten years. He was diagnosed and treated as ＂chronic eczema＂ in a number of hospitals, but the effect was not good. Physical examination showed both buttocks was distributed diffuse mousy proliferative plaques on bilateral buttock unapparent bulges beside on the edge of skin lesions; mousy keratoic plaques as large as from mung bean to soybean size around buttocks and thighs with bugling edge andatrophic center. Histopathological ex- amination revealed that hyperkeratosis accompanying with parakeratosis, cornoid amellae on some areas, a diminished granular layer, irregularly arranged cells on stratum spinosum, scattered dyskeratosis ceils, lymphocytic infiltration on the superficial layer of dermis. Combining clinical manifestations with histopathological examination, the diagnosis is vulvar buttock genitogluteal porokeratosis.