Background Inflammatory linear verrucous epidermal nevus(ILVEN)is a rare type of epidermal nevus that occurs in infancy and develops along Blaschko’s lines.Due to its rarity and clinical/histological similarities wit...Background Inflammatory linear verrucous epidermal nevus(ILVEN)is a rare type of epidermal nevus that occurs in infancy and develops along Blaschko’s lines.Due to its rarity and clinical/histological similarities with other cutaneous disorders,correct diagnosis is sometimes difficult.In the present case,the whole exome sequencing of blood found no germline mutation,but the sequencing of the biopsy specimen revealed a novel potential pathogenic somatic mutation,C>T at rs200881715(p.R698X)in the cspp1 gene,which may provide new insight into the mechanism of ILVEN.Patient concerns A 10-year-old girl presented with linear,pruritic,erythematous,scaly,and exophytic verrucous skin lesions on her left thigh,buttock,and hand unilaterally along Blaschko’s lines from the third day after birth.Diagnosis Biopsy revealed psoriasiform acanthosis,papillary hyperplasia with orthohyperkeratosis,and parakeratosis of squamous epithelium,which are histological characteristics of ILVEN.Interventions Owing to the large lesion size and significant refractory response to previous treatments,multiple-stage surgical resections with a tissue expander were performed.Outcomes After surgical resection and defect reconstruction with a tissue expander,the outcome was satisfactory for the patient and her family.No recurrence was detected during the follow-up visits.Conclusion ILVEN is a rare type of cutaneous hyperplastic disease,and treatment is extremely challenging.Biopsy should be performed at the diagnostician’s discretion or if refractory to conservative treatments.Timely diagnosis and surgical intervention could result in satisfactory outcomes.展开更多
目的探讨行腹腔镜下右半结肠癌根治术患者消化道重建时使用倒刺线关闭共同开口及加固吻合口的有效性和安全性。方法选择2021年1月至2022年12月于河南省肿瘤医院行右半结肠癌根治术患者82例为研究对象。根据术中消化道重建方法将患者分...目的探讨行腹腔镜下右半结肠癌根治术患者消化道重建时使用倒刺线关闭共同开口及加固吻合口的有效性和安全性。方法选择2021年1月至2022年12月于河南省肿瘤医院行右半结肠癌根治术患者82例为研究对象。根据术中消化道重建方法将患者分为对照组(n=40)和观察组(n=42)。对照组患者术中使用直线切割闭合器关闭共同开口,吻合口不加固;观察组患者术中使用倒刺线关闭共同开口及加固吻合口。比较2组患者消化道重建时间、使用钉仓的数量、术中出血量等手术相关指标,比较2组患者术后排气时间、术后住院时间和手术前后24 h血红蛋白(Hb)差值;记录并比较2组患者术后并发症发生率。结果观察组患者消化道重建时间长于对照组,使用钉仓数少于对照组(P<0.05);2组患者术中出血量比较差异无统计学意义(P>0.05)。2组患者术后排气时间、术后住院时间比较差异无统计学意义(P>0.05)。观察组患者手术前后24 h Hb差值小于对照组(P<0.05)。对照组和观察组患者术后并发症发生率分别为7.1%(3/42)和12.5%(5/40),2组患者并发症发生率比较差异无统计学意义(χ^(2)=0.799,P>0.05)。结论使用倒刺线关闭共同开口及加固吻合口是一种安全、可行且止血效果较好的消化道重建方法。展开更多
基金This work was supported by grants from the Youth Doctor Collaborative Innovation Team Project(QC201803)of Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai Youth Top-Notch Talent Program(201809004)Chenguang Program supported by the Shanghai Education Development Foundation and the Shanghai Municipal Education Commission(19CG18)+2 种基金the Science and Technology Commission of Shanghai Municipality(19JC1413)Shanghai Rising Star Program(20QA1405600)innovative research team of high-level local universities in Shanghai(SSMU-ZDCX20180700).
文摘Background Inflammatory linear verrucous epidermal nevus(ILVEN)is a rare type of epidermal nevus that occurs in infancy and develops along Blaschko’s lines.Due to its rarity and clinical/histological similarities with other cutaneous disorders,correct diagnosis is sometimes difficult.In the present case,the whole exome sequencing of blood found no germline mutation,but the sequencing of the biopsy specimen revealed a novel potential pathogenic somatic mutation,C>T at rs200881715(p.R698X)in the cspp1 gene,which may provide new insight into the mechanism of ILVEN.Patient concerns A 10-year-old girl presented with linear,pruritic,erythematous,scaly,and exophytic verrucous skin lesions on her left thigh,buttock,and hand unilaterally along Blaschko’s lines from the third day after birth.Diagnosis Biopsy revealed psoriasiform acanthosis,papillary hyperplasia with orthohyperkeratosis,and parakeratosis of squamous epithelium,which are histological characteristics of ILVEN.Interventions Owing to the large lesion size and significant refractory response to previous treatments,multiple-stage surgical resections with a tissue expander were performed.Outcomes After surgical resection and defect reconstruction with a tissue expander,the outcome was satisfactory for the patient and her family.No recurrence was detected during the follow-up visits.Conclusion ILVEN is a rare type of cutaneous hyperplastic disease,and treatment is extremely challenging.Biopsy should be performed at the diagnostician’s discretion or if refractory to conservative treatments.Timely diagnosis and surgical intervention could result in satisfactory outcomes.
文摘目的探讨行腹腔镜下右半结肠癌根治术患者消化道重建时使用倒刺线关闭共同开口及加固吻合口的有效性和安全性。方法选择2021年1月至2022年12月于河南省肿瘤医院行右半结肠癌根治术患者82例为研究对象。根据术中消化道重建方法将患者分为对照组(n=40)和观察组(n=42)。对照组患者术中使用直线切割闭合器关闭共同开口,吻合口不加固;观察组患者术中使用倒刺线关闭共同开口及加固吻合口。比较2组患者消化道重建时间、使用钉仓的数量、术中出血量等手术相关指标,比较2组患者术后排气时间、术后住院时间和手术前后24 h血红蛋白(Hb)差值;记录并比较2组患者术后并发症发生率。结果观察组患者消化道重建时间长于对照组,使用钉仓数少于对照组(P<0.05);2组患者术中出血量比较差异无统计学意义(P>0.05)。2组患者术后排气时间、术后住院时间比较差异无统计学意义(P>0.05)。观察组患者手术前后24 h Hb差值小于对照组(P<0.05)。对照组和观察组患者术后并发症发生率分别为7.1%(3/42)和12.5%(5/40),2组患者并发症发生率比较差异无统计学意义(χ^(2)=0.799,P>0.05)。结论使用倒刺线关闭共同开口及加固吻合口是一种安全、可行且止血效果较好的消化道重建方法。
