HIV感染合并皮肤鳞状细胞癌3例

Three cases of human immunodeficiency virus infection combined with cutaneous squamous cell carcinoma

皮肤鳞状细胞癌(cSCC)是一种起源于表皮或附属器角质形成细胞的恶性肿瘤,主要以皮肤结节起病,逐渐增大,后期中央可出现溃疡,表面常有出血或覆盖脓性分泌物。感染HIV使细胞介导免疫功能受损,增加cSCC发病风险且使肿瘤更具侵袭性,导致患者预后不良。本文报道了3例HIV感染合并皮肤鳞状细胞癌患者的临床表现、体征及影像学表现,3例患者均以皮肤结节起病,皮肤病变进展迅速,其中1例出现邻近骨质破坏,明确诊断后行截肢治疗;1例出现淋巴结转移及肺转移,在明确诊断后数月死亡;1例迅速进展后侵犯肛管,无法手术;3例患者均预后不良。HIV感染患者出现皮肤肿物和溃疡,需要警惕cSCC的可能,应当尽早行病理学检查,明确诊断,及时治疗。

Cutaneous squamous cell carcinoma(cSCC)is a malignant neoplasm originating from the epidermis or accessory organ keratin-forming cells.It mainly starts with skin nodules,gradually increases in size,and in the later stage,ulcers may appear in the center,often with bleeding or covered with purulent secretions on the surface.Infection with human immunodeficiency virus impairs cell-mediated immune function,increases the risk of cSCC and makes tumors more invasive,leading to poor prognosis.This paper reports the clinical manifestations,physical characteristics and imaging of three patients with HIV infection combined with cSCC.All three patients developed from skin nodules,and the skin lesions progressed rapidly.Among them,one case had near bone destruction and was amputated after clear diagnosis,one case had lymph node metastasis and pulmonary metastasis,which was clearly diagnosed dead a few months later,one case violated the anal canal after rapid progression and was inoperable,and three patients had a poor prognosis.HIV infected patients with skin lesions and ulcers need to be alerted to the possibility of cSCC,and pathological examination should be performed as soon as possible to clarify the diagnosis and provide timely treatment.