等离子联合光动力治疗脚趾鲍温病1例并文献复习

Bowen′s disease of toe treated with plasma combined with photodynamic therapy:A case report and literature review

报告1例脚趾鲍温病。患者女,39岁。左拇趾内侧皮肤红色斑块1月余。1月余前患者发现左拇趾内侧皮肤红斑丘疹,无自觉症状。外用糖皮质激素治疗无效。5~6年前曾于患处出现类似皮疹,并于外院进行手术切除,结果不详。皮肤科查体:左拇趾内侧皮肤可见一约1.5 cm×1.5 cm浸润性红斑,略突出于皮面,边界较清楚;中央见0.5 cm×0.3 cm左右暗红色痂壳。皮损组织病理检查显示表皮全层鳞状上皮异形增生。诊断:鲍温病。予等离子烧灼去除肉眼可见病灶后,5-氨基酮戊酸光动力治疗4次,皮损完全消退。电话随访1年无复发。

A case of Bowen′s disease of toe is reported.A 39-year-old woman presented with red asymptomatic lesion on the medial side of the left big toe for over a month.Topical treatment with glucocorticoid was not effective.A similar rash appeared on the same area 5 to 6 years ago,and was surgically removed.Clinical examination revealed a demarcated red plaque 1.5 cm×1.5 cm in diameter,with dark red crust in the center,on her big left toe.The histopathological examination of the skin lesion showed heteroplasia of the squamous epithelium in the epidermis.The diagnosis was Bowen′s disease.Following removal of lesion with electrocauterization,5-aminolevulinic acid photodynamic(ALA-PDT)was given 4 times.The lesion completely subsided with no recurrence during 1-year telephone follow-up.