播散性浅表性光线性汗孔角化症21例临床病理分析

目的探讨播散性浅表性光线性汗孔角化症临床和组织病理学特点。方法回顾性分析本科1995年1月～2012年1月间断收治的21例播散性浅表性光线性汗孔角化症患者的临床和组织病理学资料。结果 21例患者中男女比例为1.1∶1(男11例,女10例)。20岁前发病者13例(61.91%),(20～50)岁7例(33.33%),>50岁1例(4.76%),平均发病年龄18.36岁。皮损位于曝光部位,累及面部者10例(47.62%),累及颈部者9例(42.86%),累及上肢者19例(90.48%),累及下肢者7例(33.33%),累及躯干者6例(28.57%)。其中4例有家族史(占19.05%)。3例合并有系统疾病。组织病理资料分析均可见典型的角化不全柱,其下方颗粒层减少或消失。结论播散性浅表性光线性汗孔角化症20岁前发病多见,男女发病率大致相当,皮损位于暴露部位。组织学上以表皮角质层内典型的角化不全柱伴其下方颗粒层减少或消失为特征。

Clinical and histopathological features of 21 cases with disseminated superficial actinic porokeratosis

Objective To analyze the clinical and histological features of disseminated superficial actinic porokeratosis. Methods The clinical and histopathological data of 21 cases with disseminated superficial actinic porokeratosis in our department from January 1995 to January 2012 were collected and retrospectively analyzed. Results The clinical data have shown that the ratio of male to female was 1.1 ： 1 patients whose onset ages were under 20 years ; 7 patients were 20 - 50 years old, and 1 patients was over 50 years old ; the mean age of onset was 18.36 years. It affected only sun-exposed areas which include face （10 cases）, neck （9 cases）, upper extremities （19 ea- ses）, lower extremities （7 cases） and trunk （ 6 cases）. Of these patients four cases （ 19.05 % ） had family history, three cases accompa- nied with systemic diseases. Histopathologic examinations commonly presented a eornoid lamella overlying an absent granular layer. Con- elusion Disseminated superficial actinic porokeratosis almost exclusively involved sun-exposed areas of the skin and mostly developed before age 20 years. The distinctive histopathological feature was a column of parakeratotic cells （known as the eornoid lamella） overlying an absent granular laye.