融合性网状乳头瘤病32例临床分析

Clinical Analysis of 32 Patients with Confluent Reticulate Papillomatosis

目的探讨融合性网状乳头瘤病(confluent and reticulated papillomatosis,CRP)的临床、组织病理表现及治疗反应特点。方法回顾性分析西安交通大学第二附属医院2010年1月-2019年4月间诊治的32例CRP患者的临床特点、组织病理表现及治疗效果。结果 32例患者平均发病年龄22岁(13~62岁),其中男14例,女18例(56.25%),平均病程2.84年(20 d^20^+年)。皮损主要分布于躯干部位(乳间、上腹部、肩胛区及颈部),表现为多量密集的淡褐色扁平丘疹,皮损中间融合,周围呈网状。组织病理主要表现为角化过度,棘层肥厚,乳头瘤样增生。治疗效果:25例患者治疗方式不详(其中1例现已痊愈);2例患者给予口服异维A酸胶囊,外用阿达帕林凝胶联合抗真菌治疗,病情反复;剩余5例患者均给予口服米诺环素治疗,现已痊愈,随访无复发。结论 CRP多发生于青春期或青春后期,多见于女性。皮损主要位于躯干上部,也可累及其他少见部位,组织病理有时不典型。米诺环素治疗该病效果较好。

Objective To investigate the clinical,histopathological findings and therapeutic effect of confluent and reticulate papillomatosis(CRP).Methods The clinical presentation,histological findings and response to treatment of 32 patients with CRP diagnosed between January 2010 and April 2019 in the Second Affiliated Hospital of Xi'an Jiaotong University were retrospectively analyzed.Results Mean age at onset of the skin eruption was 22 years(range 13~62 years),18 patients(56.25%)were female,and the skin eruption had been present for a mean of 2.84 years(range 20 days^20 years).Typical clinical findings were brown macules and patches distributed on the intermammary,epigastric area,neck and lower back,with a reticular pattern in the periphery and confluence at the center of the lesions.Skin biopsy specimens from 32 patients showed hyperkeratosis,papillomatosis and focal acanthosis.Twenty-five patients were not treated,and one of whom was cured.Two patients were given isotretinoin and topical adapalene gel combined with antifungal therapy,and the condition was relapsed.Minocycline was prescribed for 5 patients among them,and the lesions had completely resolved and no recurrence in follow up. Conclusion CRP occurs mostly in the teens and young adults,and it ispredominately in female. Skin eruption is mainly located in the trunk,and may alsoinvolve other rare sites. Histopathological findings are sometimes atypical. Minocyclineis highly effective in most patients.