异维A酸治疗播散性浅表性光线性汗孔角化症

A case of disseminated superficial actinic porokeratosis treated with isotretinoin

患者女,68岁。全身散在褐色角化性丘疹伴瘙痒2年余。皮损组织病理检查示角化过度,表皮增生,柱状角化不全,部分角化不全柱下可见部分角化不良细胞,真皮浅层片状淋巴细胞浸润。全基因组外显子测序提示患者MVK基因突变。诊断:播散性浅表性光线性汗孔角化症,治疗:口服异维A酸软胶囊、抗组胺药和外用维A酸药物3个月余,皮疹逐渐消退,瘙痒缓解,目前患者仍在随访中。

A 68-year-old woman had discrete brown keratinized papule with pruritus all over the body for more than 2 years. Histopathologic examination showed hyperkeratosis, epidermal hyperplasia, incomplete columnar keratinization, some keratinized cells with partial keratinization, and lamellar lymphocyte infiltration in superficial dermis. Genome-wide exome sequencing suggested MVK gene mutations. It was diagnosed as disseminated superficial actinic porokeratosis. After treatment of oral isotretinoin, antihistamine and external retinoic acid for more than 3 months, the skin lesions gradually subsided and the pruritus was under control. The patient is now being followed up.