异维A酸致男性乳房发育症1例国内首报

Gynecomastia Following Isotretinoin Treatment:The First Reported Case in China

患者男,22岁,双侧乳房增大伴痛2个月。患者3个月前因痤疮服用异维A酸,2个月前发现双侧胸部轻度疼痛,随后乳房增大,疼痛加重。外院乳腺B超示:男性双侧乳腺发育。体检:双乳对称,外观正常,触诊可扪及双侧乳腺增大,左侧为著,按压疼痛。复查乳腺B超示:左侧胸部乳头下方1.5 cm×0.5 cm腺体样回声,右侧无异常。异维A酸停药4个月后,乳房恢复正常。结合患者临床表现、异维A酸用药史及停药前后乳腺B超的变化,诊断为男性乳房发育症(gynecomastia,GYN),考虑与口服异维A酸治疗痤疮有关。

A 22-year-old male presented with bilateral breast enlargement and pain for two months.The patient was treated with oral isotretinoin for acne three months ago.He started experiencing mild pain in both breasts two months ago,which subsequently led to obvious enlargement and pain.Ultrasound of the breasts showed bilateral mammary gland development.Physical examination revealed no abnormal appearance of the mammary glands.Palpation revealed bilateral enlargement of the mammary gland,notably on the left side,with pain when applying pressure.On reexamination of breast ultrasound findings,no abnormality was detected in the right chest,and a glandular echo of 1.5 cm×0.5 cm was observed below the left nipple.The breast returned to normal four months after the withdrawal of isotretinoin.Based on the patient′s clinical manifestations,medication history,and changes in breast ultrasound before and after the withdrawal of isotretinoin,a diagnosis of gynecomastia was made.We consider that gynecomastia is related to the treatment of acne with isotretinoin.