临床上容易被误诊的足背部扁平疣1例报告

A case report of flat wart on dorsal part of foot which is easily misdiagnosed in clinic

扁平疣是由人乳头瘤病毒(HPV)感染引起的一种皮肤病。近年来发病率越来越高,主要发生于面部、手背、手臂等暴露部位,对患者尤其是女性的外貌和心理健康造成极大的影响,扁平疣的治疗方法多种多样,患者应根据自身病情和医生建议选择合适的治疗方法。综合治疗是目前扁平疣治疗的趋势,通过联合应用多种治疗方法以提高疗效、减少复发。本例患者由于临床表现与典型扁平疣有诸多不同,如老年发病、发于足背部、剧烈瘙痒、皮疹隆起呈结节状等表现,临床极易误诊,诊疗初期并没有往扁平疣考虑,而是以慢性湿疹、扁平苔藓、结节性痒疹来处理。使用糖皮质激素乳膏与抗组胺药物治疗患者症状未见改善,直至病理结果提示扁平疣后才选择重组人干扰素a-2b凝胶外用,每日2次;治疗1个月后复诊,皮损大部分已消退,瘙痒感明显减轻,效果满意。由于前期未考虑扁平疣,因此未行HPV分型检测。

Flat wart is a skin disease caused by human papillomavirus(HPV)infection.In recent years,the morbidity is getting higher and higher,mainly in exposed parts such as face,dorsal part of hand and arm,etc.which has a great impact on the appearance and mental health of patients,especially women.There are various treatment methods for flat warts,and patients should choose the appropriate treatment method according to their own condition and doctor’s advice.Comprehensive treatment is the trend of the treatment of flat warts at present,and multiple treatment methods are combined to improve the therapeutic efficacy and r educe the relapse.Because the clinical manifestations of this patient are different from those of typical flat warts,such as senile onset,occurrence on dorsal part of foot,severe itching,and nodular appearance of the rash,it is easy to be misdiagnosed in clinic.In the initial stage of diagnosis and treatment,flat warts were not considered,but rather chronic eczema,lichen planus and nodular prurigo were treated.The symptoms of patients treated with glucocorticoid cream and antihistamine drugs did not alleviate until the pathological results indicated flat warts,and recombinant human interferon a-2b gel was selected for external use,bid;Following up after 1 month of treatment,most of the skin lesions have subsided,and the itching sensation has been obviously alleviated,and the efficacy was satisfactory.Because flat wart was not considered in the early stage,HPV ty ping was not tested.