少见型角化棘皮瘤的诊断与治疗

Diagnosis and treatment in cases of unusual type of keratoacanthoma

目的 : 探讨少见型角化棘皮瘤 (KA)的诊断及治疗方法。方法 : 对 2例病人的临床和组织学表现进行分析 ,观察了阿维A的治疗效果 ,并对相关文献作了复习。结果 : 2例组织学改变均符合KA。根据它们的临床表现和组织学特征 ,分别诊断为边缘离心性KA和发疹性KA。口服阿维A 2 0～ 30mg d ,2个月 ,皮损全部消退。结论 : 少见型KA依据临床和组织病理学特征可作出诊断。阿维A可作为治疗该型KA的首选药物。

Objective:To explore the diagnosis and treat ment of patients with unusual type of keratoacanthoma (KA). Methods: The clinical and histological findings as well as the efficacy of ac itretin therapy were analyzed. In addition,the pertinent literatures were revie wed. Results: The histological changes in both cases were in accordance with KA. According to the clinical manifestations and histological changes,one case was diagnosed as keratoacanthoma centrifugum marginatum and t he another one as eruptive keratoacanthoma. The differential diagnosis of these two types of KA was discussed. Oral acitretin therapy was performed at 20～30 mg /d,and the skin lesions completely disappeared within two months. Conclusion :The diagnosis of these two types of KA can be confi rmed by clinical and histological features. Oral acitretin in a low dosage could be the first choice for the treatment of these types of KA.