胸部淡红色斑--丹毒样癌

患者女，57岁。因右胸和左乳房部出现红斑10个月就诊。10个月前，患者在无明显诱因下，右胸部出现大片红斑，偶感轻度瘙痒，未曾就诊治疗。此后．红斑逐渐扩展至左乳房。既往史：患者2年前有右乳腺癌史．在当地行右乳房切除术和右腋窝淋巴结清扫术。有高血压史10年，一直服用降压药物治疗（具体不详），血压控制尚可。体格检查：一般情况可，各系统检查无异常，

以颈部、胸背部红斑为首发症状的胃癌1例

1 病历摘要患者男,48岁,因左侧颈部、胸背部红斑、肿胀伴痛痒3个月入院。3个月前,无明显诱因,患者左侧颈部出现花生豆大红斑,伴轻微痛痒。病情发展,皮损逐渐增多、增大累及左侧颈部、胸背部,伴痛痒明显,左上肢肿胀明显。自发病以来,患者无发热、体重下降等症状。既往史:脊髓灰质炎40余年,未予治疗;胃溃疡20余年,规律口服奥美拉唑(20 mg/d)或泮托拉唑(40 mg/d),无特殊不适,家族史无类似病史患者。

叙述性回顾:外观类似感染性蜂窝织炎的疾病

For cellulitis that does not respond to conventional antimicrobial treatment, clinicians should consider, among other explanations, several noninfectious diso rders that might masquerade as infectious cellulitis. Diseases that commonly mas querade as this condition in clude thrombophlebitis, contact dermatitis, insect stings, drug reactions, eosinophilic cellulitis (the Wells syndrome), gouty arth ritis, carcinoma erysipelatoides, familial Mediterranean fever, and foreign-bod y reactions. Diseases that uncommonly masquerade as infectious cellulitis includ e urticaria, lymphedema, lupus erythematosus, sarcoidosis, lymphoma, leukemia, P aget disease, and panniculitis. Clinicians should do an initial diagnostic work -up directed by the findings from a detailed history and complete physical exam ination. In many cases, skin biopsy is the only tool that helps identify the cor rect diagnosis. Special tests may also be needed.

医海拾贝

这是一位患类丹毒样癌症(乳腺癌皮肤转移)的70多岁女性患者(上图),因8个月来躯干和左臂出现进展性无症状皮疹而就医转诊前,患者曾被怀疑患有湿疹和蜂窝织炎,但局部应用类固醇和口服抗生素治疗均无效3患者有左侧三阴性乳腺癌史,8年前曾接受乳房切除术治疗。检查发现有硬化的红斑,延伸到左侧的躯干、颈部和手臂,并横跨右侧乳房。活检后确诊。预后不佳,诊断后患者通常仅有数月的生存期。