恶性黑棘皮病并发Leser-Trélat征及牛肚掌

Malignant acanthosis nigricans with Leser-Trélat sign and tripe palms: a case report

报告1例恶性黑棘皮病并发Leser-Trélat征及牛肚掌。患者男,77岁。面部、腋窝变黑7个月,躯干及上肢褐黑色斑丘疹6个月,1年前行胃癌根治性切除术。皮肤科检查:面部、颈部、胸部、背部及双上肢可见200余个米粒至黄豆大圆形或椭圆形扁平褐色斑丘疹。面部及双侧腋窝可见色素沉着,腋下、眶周及唇部乳头瘤样病变,双侧手掌散在粟粒状细小光滑乳头状凸起,呈牛肚掌样外观。皮损组织病理检查:角化过度,棘层肥厚呈乳头瘤样增生,棘层内可见角囊肿。诊断:恶性黑棘皮病并发Leser-Trélat征及牛肚掌。

A case of malignant acanthosis nigricans with Leser-Trelat sign and tripe palms is reported. A 77-years-old man presented with progressive blackening face and neck for 7 months, and brown-black maculopapules on the upper limbs and trunk for 6 months. The patient had a history of radical gastrectomy for gastric adenocarcinoma 1 year ago. Physical examination showed about two hundred round brown maculopapules on his face, neck and limbs, in the size of rice to soya bean. Pigmentation could be seen on the face and bilateral axillae. Papillomatous hyperplasia was also present on his axillae, upper lip and around the orbits. Both palms were scattered with the small, smooth, papillary hypertrophy, resembling a moss-like appearance. Histopathological examination showed hyperkeratosis, acanthosis, and keratin cysts in the spinous layers. The diagnosis of malignant acanthosis nigricans with Leser-Trelat sign and tripe palms was made.