乳房外湿疹样癌

患者男,52岁。主诉:阴囊、阴茎红斑10年,加重伴糜烂、渗出1年。现病史:患者10年前无明显诱因左侧阴囊部出现小片状红斑,伴轻度瘙痒,未予诊治。后红斑逐渐扩大,曾在当地医院就诊,诊断为阴囊湿疹,给予糖皮质激素外用治疗,皮损无明显缓解,并逐渐加重,皮损面积扩大,累及右侧阴囊及阴茎。1年前皮损表面出现糜烂、渗出,为求进一步诊治于2004年9月10日来我院就诊。个人史、家族史:既往体健,否认有药物过敏史,家族中无类似疾病患者。体格检查:一般情况好,各系统检查无异常,全身浅表淋巴结未触及增大。皮肤科检查:整个阴囊、阴茎及耻骨部大片浸润性红…     

乳房外湿疹样癌1例

患者男，72岁。因阴囊红斑、鳞屑伴瘙痒10余年，累及阴茎、腹股沟，伴破溃、渗液、出血8个月，于2002年11月入院。患者入院前10余年阴囊出现数个黄豆至钱币大红斑，表面覆细小鳞屑，伴瘙痒，曾在当地医院诊断为“阴囊湿疹”，经治疗曾一度好转，此后反复发作，至入院前8个月，皮损开始迅速扩展，逐渐累及阴茎、腹股沟，皮损呈暗红色，糜烂破溃、渗液出血，部分皮损呈浸润性斑块，伴疼痛。患者既往身体健康，否认药物过敏史。     

乳房外湿疹样癌1例

乳房外湿疹样癌是一种好发于大汗腺分布部位的恶性肿瘤。本病例发生于腋部,临床上极为少见,现报道如下。临床资料患者女,63岁。于1993年开始于左腋部出现豌豆大小红斑,表面少许渗出,偶痒。曾被当地医院诊断为湿疹,给予多种糖皮质激素软膏外用,疗效不佳。自1998年开始,斑片逐渐扩大,有鸡蛋大小,有微痛感。于2000年5月来我院就诊。家族中无类似病史。查体:一般情况尚可,无发热,各系统检查未见明显异常,浅表淋巴结未见肿大。皮肤科检查:左腋下可见形态不规则,边界清楚暗红色浸润斑片,约3.0 cm×5.0 cm,表现湿润,上覆少量鳞屑(图1)。左腋下未触…     

11例阴囊乳房外湿疹样癌手术及创面处理的临床分析

目的通过对11例阴囊乳房外湿疹样癌手术切除及创面处理效果的分析,为临床治疗提供安全可靠的治疗方法。方法根据肿瘤的大小和累及的部位,手术彻底切除病变组织,较小的创面采用直接缝合,较大的创面采用对侧阴囊旋转皮瓣修复。结果11例患者中1例直接切除缝合,10例应用对侧阴囊旋转皮瓣修复。术后随访5年,2例复发,复发率为18.91%。结论治疗阴囊乳房外湿疹样癌,彻底切除病灶并应用对侧阴囊旋转皮瓣修复创面是较为理想的手术方法。     

阴囊双蒂皮瓣修复术治疗外阴部乳房外Paget病

1临床资料 患者，男，68岁。外阴部反复起红斑、糜烂10余年。10年前患者阴阜及阴茎部无明显诱因出现红斑，稍痒，以“湿疹”多方治疗无效，皮损逐渐扩大，并延及阴前部，伴糜烂及渗出。既往无遗传病史，家族中无类似病史。系统检查无异常。皮肤科情况：     

乳房外Paget病1例

乳房外Paget病，又称乳房外湿疹样癌（EMPD），是一种少见的疾病，常发生于中老年人，临床上易误诊，近日我科诊治1例，现报道如下。     

乳房外Paget病1例

乳房外Paget病，又称乳房外湿疹样癌(EMPD)，是多发于中老年人的较少见疾病．临床上易于误诊，我科近日诊治1例，现报告如下。     

阴股沟皮瓣在修复女性尿生殖三角区恶性肿瘤切除术后皮肤软组织缺损中的临床应用

【摘要】 目的 探讨阴股沟皮瓣在修复女性尿生殖三角区恶性肿瘤切除术后皮肤软组织缺损中的临床应用。方法 对2015年1月至2017年12月沈阳市第七人民医院皮肤外科收治的10例女性尿生殖三角区恶性肿瘤患者（乳房外湿疹样癌7例，鳞状细胞癌3例）行肿瘤Mohs显微描记扩大切除，术中采用以阴部内动脉穿支血管为蒂的穿支皮瓣（其中单侧8例，双侧2例）修复外阴缺损创面。结果 10例患者，12个皮瓣全部成活，其中2例切口有轻度感染，经换药完全愈合，其余切口均一期愈合。术后随访6个月至1年，患者外阴部形态丰满，富有弹性，阴道口无狭窄，瘢痕无明显挛缩，肿瘤无复发。结论 以阴部内动脉穿支血管为蒂的阴股沟皮瓣修复女性尿生殖三角区皮肤软组织缺损效果较好。     

乳房外Paget病1例

<正>1临床资料患者男,55岁。主因阴囊右侧红斑、糜烂1年就诊。1年前无明显诱因患者阴囊右侧出现硬币大小的红斑伴瘙痒,搔抓后出现糜烂、渗液。在当地多家医院按"湿疹"予多种激素类药膏外用及抗组胺药物口服治疗,效果均不佳,4个月前     

皮瓣修复小阴唇肥大伴鲍温病切除后缺损1例

35岁女性患者,左侧小阴唇淡红色斑块伴瘙痒2年,小阴唇左侧较右侧肥大,9个月前皮损处病理诊断为外阴营养不良伴表皮中度不典型增生。行楔形切口手术彻底切除皮损,术中病理示鲍温病,边缘已切净,应用左侧小阴唇皮瓣修复创面缺损,随访3个月,效果满意。     

Concordant overexpression of p-FAK and p-ERK1/2 in extramammary Paget’s disease

Focal adhesion kinase (FAK) is a tyrosine kinase which is at the crossroad of extracellular signal-regulated kinase-1/2 (ERK1/2), PI3K/Akt, MAPK and JAK/STAT signaling pathways. We have previously reported that p-ERK1/2, p-Akt, p38MAPK and p-STAT3 are overexpressed in extramammary Paget’s diseases (EMPD), this study aimed to examine the expression of phosphorylated (p)-FAK and p-ERK1/2 proteins in EMPD and to evaluate the relationships among them. Paraffin-embedded EMPD specimens (35 tissue samples from 33 patients with primary EMPD, including two samples of metastatic lymph nodes from two of the 33 patients) were subjected to immunohistochemical staining for p-FAK and p-ERK1/2. All of the 35 EMPD specimens, including all of six invasive EMPD and two metastatic lymph node specimens, showed cytoplasmic overexpression of p-FAK and nuclear overexpression of p-ERK1/2. The expression levels (% positive cells) of p-FAK and p-ERK1/2 (88.34 ± 14.66 and 91.26 ± 11.21%) in EMPD were significantly higher than those in normal skin (22.38 ± 2.13 and 29.00 ± 4.44%), respectively. The expression levels of p-FAK (95.38 ± 4.57%) and p-ERK1/2 (96.25 ± 5.01%) in the advanced EMPD showed slightly higher than that in the non-invasive EMPD (86.26 ± 15.99 and 89.78 ± 12.15%), respectively. There exhibited a significantly high positive correlation between expression levels of p-ERK1/2 and p-FAK in EMPD. The present study shows that the concordant overexpression of p-FAK and p-ERK1/2 in EMPD which is associated with the grade of malignancy of EMPD, indicating that p-FAK and p-ERK1/2 may play pivotal roles in the tumorigenesis and further malignant transduction of EMPD.     

轴型复合组织瓣在修复唇癌术后缺损中的应用

【摘要】 目的 探讨轴型复合组织瓣在修复唇癌术后缺损中的应用。方法 2012年7月至2017年12月在吉林大学第二医院皮肤科收集8例唇癌患者,切除唇部肿物后全层缺损占唇总长度的1/3～1/2,均采用以唇动脉为轴心的轴型复合组织瓣进行修复。结果 修复术后皮瓣全部存活,目前分别随访6个月至5年,均未见肿瘤复发,且唇部形态美观,功能得到改善,患者较为满意。结论 以唇动脉为轴心的轴型复合组织瓣可修复唇癌术后皮肤缺损,能较好地恢复唇的解剖结构和美学功能。     

Distal phalangeal metastasis of extramammary Paget's disease

A rare case of phalangeal metastasis of extramammary Paget's disease in a 68-year-old man is described. The patient developed an erythematous, slightly elevated area in the pubic region. A biopsy specimen demonstrated numerous, large, rounded cells with ample pale-staining cytoplasm proliferating in the epidermis. With a diagnosis of extramammary Paget's disease, he underwent wide local excision and inguinal node dissection. Eleven months postoperatively, the patient developed a tender, red, swollen right ring finger. Bone X-ray showed that the distal phalanx of the ring finger had completely dissolved. Histopathological examination demonstrated proliferation of tumor cells in the adipose tissue. They had poorer and darker cytoplasm than the Paget's cells in the epidermis of the pubic region. Immunohistochemically, these cells showed the same staining pattern as did the Paget's cells at the primary site. Accordingly, the patient was diagnosed with distal phalangeal metastasis of extramammary Paget's disease. Two weeks after the appearance of the distal phalangeal metastasis, the patient died of cancerous pleurisy. It has been reported that patients with phalangeal metastasis have a very poor prognosis.     

Outcomes of lymph node dissection in the treatment of extramammary Paget’s disease: A single-institution study

Extramammary Paget’s disease (EMPD) often invades the dermis and metastasizes to the lymph nodes. Patients with EMPD associated with lymph node metastases have poor prognosis; to date, effective treatment has not yet been established. Lymph node dissection, aiming to control the local disease, is a standard form of management for EMPD patients with lymph node metastases (LNM). We investigated the clinical and pathological features, treatment strategies and prognostic factors of patients with metastatic EMPD who underwent lymph node dissection. We retrospectively evaluated 38 cases of extramammary Paget’s disease with lymph node metastasis over 10 years. All patients underwent wide resection of the primary lesion and lymph node dissection. Univariate analysis revealed the number of metastatic nodes and lymphadenopathy as prognostic factors. In multivariate analysis, the number of metastatic lymph nodes retained statistical significance (hazard ratio, 35.3; 95% confidence interval, 3.23–387.0; P = 0.003). The 5-year survival rate was 100% and 19.1% in patients with two or less LNM and with three or more LNM, respectively. In patients with three or more LNM, the 5-year survival rate after adjuvant radiation therapy was better than that after surgery alone (75% vs 0%). In conclusion, patients with two or less LNM can be expected to have long-term survival with lymph node dissection only, while patients with three or more LNM may require adjuvant radiation therapy to improve prognosis. These results suggest that lymph node dissection may be a strategy to treat EMPD with regional LNM.     

Double involvement of extramammary Paget's disease in the genitalia and axilla

We here reported a case of an 82-year-old man with double involvement of extramammary Paget's disease in the genitalia and axilla. Physical examination revealed erythema and reddish tumors on the pubic area and scrotum and irregular-shaped erythema on the left axilla. The skin biopsy sample from the genital area showed Paget's cells in the epidermis and upper dermis. The specimen from the left axilla showed Paget's cells scattered in the epidermis but not in the dermis.