Smad7在脂溢性角化病、日光性角化病及基底细胞癌中的表达

目的： 检测Smad7在脂溢性角化病、日光性角化病以及基底细胞癌中的表达。方法：对脂溢性角化病、日光性角化病及基底细胞癌标本（各30例）和30例正常标本进行免疫组化染色。结果：23例脂溢性角化病标本、23例日光性角化病标本和28例基底细胞癌标本中Smad7染色阳性,阳性细胞率分别为（31.0±23.0）%,（32.7±26.3）%和（62.6±32.1）%,均显著高于正常组织的（6.7±5.0%）。结论： Samd7可能与脂溢性角化病、日光性角化病以及基底细胞癌的发病有关。     

Effectiveness and safety of topical calcipotriol in the treatment of flat seborrheic keratosis on the face

Seborrheic keratosis is the most common slow-growing, benign epithelial tumour, usually appearing on sun-exposed areas. Treatment modalities for seborrheic keratosis may be uncomfortable and/or time-consuming. We present a case series of 12 patients with solitary seborrheic keratosis localized on the face treated with 0.005% calcipotriol ointment. The treatment lasted 3–8 months and resulted in complete regression of the lesions. Remission (follow-up period) lasted from 6 to 10 years. We conclude that topical calcipotriol may be a useful treatment option for seborrheic keratosis.     

Two Cases of Basal Cell Carcinoma Arising in Seborrheic Keratosis

The present study reports two cases of basal cell carcinoma arising in seborrheic keratosis. The first case is a seventy-three-year-old female who presented with a blackish nodule arising from a pigmented lesion on her chest. Histopathological analysis of the nodule and the pigmented lesion revealed a basal cell carcinoma with hair follicular differentiation and an acanthotic seborrheic keratosis, respectively. The second case is a seventy-year-old female with a blackish nodule arising from a pigmented lesion on her back. Histological analysis of the nodule revealed an atypical basaloid cell mass surrounded by a seborrheic keratosis lesion. In addition to the coexisting seborrheic keratosis with the basal cell carcinoma, a basaloid follicular hamartoma that showed muliple hamartomatous hair follicles or small cysts replaced by a branching cord or lace-like network of basaloid cells surrounded by fibrovascular stroma was identified. We concluded that both cases presented a rare combination of a seborrheic keratosis which underwent a malignant change to basal cell carcinoma. It appears that both basal cell carcinomas and seborrheic keratosis may derive from a similar source: pluripotential cells of either the epidermis or hair follicle epithelium.     

EGFR、PTEN、c-Jun和MMP-1在面部脂溢性角化病中的表达及意义

目的:检测皮肤光老化传导通路中的4个关键因子表皮生长因子受体(EGFR)、10号染色体同源丢失性磷酸酶-张力蛋白(PTEN)、转录因子活化蛋白-1(AP-1)的主要组分c-Jun、以及基质金属蛋白酶-1(MMP-1)蛋白在面部脂溢性角化病(SK)及面部正常皮肤组织中的表达,探讨SK的发病与皮肤光老化的相关性。方法:应用免疫组织化学染色及EVG染色技术检测54例面部SK患者皮损标本和20例面部正常者皮肤标本(对照组)中EGFR、PTEN、c-Jun和MMP-1的蛋白表达及弹力纤维的含量变化情况。结果:SK组中的EGFR、c-Jun和MMP-1表达均高于对照组(Z值分别为-4.45,-2.33,-2.37,P值均<0.05),PTEN的表达略低于对照组(Z=-1.55,P>0.05);Spearman等级相关分析表明SK皮损中EGFR、c-Jun与MMP-1表达呈正相关(r值分别为0.71、0.69,P值均<0.05),PTEN与MMP-1的表达呈负相关(r=-0.31,P<0.05);SK皮损下方真皮中弹力纤维变性情况较对照组明显,且皮损下方弹力变性组织堆积随年龄增长而增加(P<0.05),而胶原蛋白减少。结论:与皮肤老化有关的生物学指标EGFR、c-Jun、PTEN、MMP-1表达的变化及真皮中弹力纤维变性增加,提示皮肤光老化与SK的发生相关,面部SK可能是在光老化的基础上产生。     

Occult Basal Cell Carcinoma Arising in Seborrheic Keratosis

The present study reports a case of an occult basal cell carcinoma that arose in seborrheic keratosis. The patient was a fifty-six-year-old male who presented with a dark brown plaque on his back. Clinically, the lesion demonstrated no nodules or ulcerations suggesting that it was malignant. However, histopathological analysis of the lesion revealed an atypical basaloid cell mass that appeared to be a solid basal cell carcinoma beneath and surrounded by a seborrheic keratosis lesion. Thus, the coexistence of basal cell carcinoma and seborrheic keratosis is possible and should be considered when a malignant change in seborrheic keratosis is apparent.     

青年面部多发性脂溢性角化病35例临床分析

青年面部多发性脂溢性角化病临床易误诊为扁平疣,本文对35例青年面部脂溢性角化病患者临床资料进行分析,临床特征总结如下:(1)扁平丘疹大小、形态均匀对称;(2)常伴有皮赘;(3)面部皮疹多分布于颊部、颞部、额角及颧部等;(4)无扁平疣自身接种现象。     

Seborrheic keratosis with focal acantholysis

A case of a 70-year-old man with several dome-shaped tumors with acantholysis was reported. The histopathological findings of these black-brownish colored tumors on the back were compatible with seborrheic keratosis, consisting of basaloid and squamoid cells. Although three cases reported by Tagami et al. (1978) and Uchiyama et al. (1986) showed intraepidermal epithelioma-like tumor nests in the acanthotic lesions, our case was thought to correspond to another variant of seborrheic keratosis with acantholysis.     

皮肤镜诊断黑素细胞痣、脂溢性角化和日光性角化与组织病理诊断的一致性

目的：评价皮肤镜诊断黑素细胞痣、脂溢性角化、日光性角化的准确度。方法：收集临床怀疑为黑素细胞痣、脂溢性角化和日光性角化的病例,由两位医生参照目前皮肤镜诊断标准对该三种皮肤肿瘤进行盲法独立诊断,并与组织病理结果相对照。结果：与组织病理诊断比较,(1)A、B两位医生使用皮肤镜诊断黑素细胞痣一致率（89.3%、91.2%）、灵敏度（94%、95.2%）、特异度（84.2%、86.8%）、误诊率（15.8%、13.2%）、漏诊率（6%、4.8%）。(2)A、B两位医生使用皮肤镜诊断脂溢性角化一致率（88%、91.7%）、灵敏度（91.7%、95.8%）、特异度（83.6%、86.9%）、误诊率（16.4%、13.5%）、漏诊率（8.3%、4.2%）;(3)A、B两位医生使用皮肤镜诊断日光性角化一致率（84.1%、86.4%）、灵敏度（87.5%、87.5%）、特异度（17.9%、12.5%）、误诊率（82.1%、85.7%）、漏诊率（17.9%、14.3%）。结论：皮肤镜诊断黑素细胞痣、脂溢性角化和日光性角化的结果与病理诊断结果均有较好的一致性。     

皮肤良、恶性增殖性疾病中△Np63的检测

目的观察△Np63在皮肤良、恶性增殖性疾病中的表达,并探讨其意义。方法应用免疫组化SP法检测30例脂溢性角化症、30例日光性角化病、30例基底细胞癌及10例正常皮肤组织中△Np63的表达,并采用Image-Pro Plus6.0(IPP)图像分析软件定量测定每个视野中阳性表达的平均光密度值。结果△Np63在脂溢性角化症组表达的平均光密度为0.0391±0.0169,日光性角化病组为0.0262±0.0184;基底细胞癌组为0.0498±0.0222;正常皮肤组为0.0056±0.0019。△Np63在各组的阳性表达差异有统计学意义(P<0.05),它除在脂溢性角化症及基底细胞癌组的表达差异无统计学意义(P>0.05)外,余组内两两比较的差异也均有统计学意义(P均<0.05);但是它在不同部位的脂溢性角化症、日光性角化病和基底细胞癌中的表达差异均无统计学意义(P均>0.05)。结论再次印证了△Np63是未分化上皮来源肿瘤的标记物。     

Differentiation disorders of keratinocytes in seborrheic keratosis (acanthotic type).

Since the differential disorder of keratinocytes in seborrheic keratosis remains to be elucidated, the differentiation of seborrheic keratosis (acanthotic type) was examined immunohistochemically using a lectin and two anti-keratin monoclonal antibodies. A lectin, peanut agglutinin (PNA), and anti-keratin monoclonal antibody, 34 beta B4, recognize the whole epidermis except for the basal layer in the normal epidermis. In seborrheic keratosis (acanthotic type), cells unstained with either PNA or 34 beta B4 were found throughout the entire tumor. In the upper part of the tumor, some cells appeared to undergo keratinization without expressing the differential markers recognized by PNA or 34 beta B4. Another anti-keratin monoclonal antibody, 34 beta E12, stained the tissues in the same way as in the normal epidermis. Thus it was indicated that, in seborrheic keratosis (acanthotic type), although differentiation was partially maintained, some cells might undergo maturation without expressing the differentiation markers recognized by PNA or 34 beta B4.     

脂溢性角化病96例和日光性角化病28例临床与病理分析

目的观察脂溢性角化病(SK)与日光性角化病(AK)的临床及病理差异。方法回顾性分析本科门诊2006年1月-2011年7月经病理确诊的96例SK和28例AK患者的临床及病理资料,对数据用Excel整理与分析。结果①SK好发于中老年人,而AK好发于老年人;②SK皮损好发于头面、躯干及四肢,而AK好发于头、面和颈等光暴露部位;③组织病理:SK以角化型和棘层肥厚型为主,而AK以原位癌型和萎缩型为主;④SK临床与组织病理的诊断符合率为70.83%,而AK临床与组织病理的诊断符合率仅为46.43%,临床上易将AK误诊为SK。结论 AK发病晚于SK,临床上AK误诊率高于SK,两者鉴别诊断主要依赖组织病理。     

A Possible Case of Eccrine Poroma Arising in Seborrheic Keratosis with Partial Intermediate Malignancy and Tumor of the Follicular Infundibulum

An eighty-year-old woman presented with a eccrine poroma that appeared to have arisen in a seborrheic keratosis lesion on the right side of her abdomen. The tumor consisted of a brownish, flat, elevated lesion with an eroded nodule at its periphery. Histopathological analysis of the flat, elevated lesion revealed benign basaloid and squamoid cells that showed acanthotic upward proliferation, suggesting a seborrheic keratosis. The eroded nodule showed irregular proliferation of slight atypical squamoid cells with, in parts, ductal structures in the upper dermis, suggesting that it was an eccrine poroma with partial intermediate malignancy. In addition to the eroded nodule, an occult tumor clinically accompanied the seborrheic keratosis. Histopathology of the occult tumor revealed fenestrated columns and cords of pale epithelial cells attached to the base of the seborrheic keratosis lesion, which was diagnosed as a tumor of the follicular infundibulum. Although reports of seborrheic keratosis transforming into a sweat gland tumor are rare, the present case suggests that seborrheic keratosis may develop into benign or malignant adnexal tumors, including sweat gland and follicular tumors. Thus, seborrheic keratosis should be considered as a possible precursor of adnexal tumor.     

Melanoma and seborrheic keratosis differentiation using texture features

Purpose: To explore texture features in two-dimensional images to differentiate seborrheic keratosis from melanoma.
Methods: A systematic approach to consistent classification of skin tumors is described. Texture features, based on the second-order histogram, were used to identify the features or a combination of features that could consistently differentiate a malignant skin tumor (melanoma) from a benign one (seborrheic keratosis). Two hundred and seventy-one skin tumor images were separated into training and test sets for accuracy and consistency. Automatic induction was applied to generate classification rules. Data analysis and modeling tools were used to gain further insight into the feature space.
Result and Conclusions: In all, 85–90% of seborrheic keratosis images were correctly differentiated from the malignant skin tumors. The features correlation_average, correlation_range, texture_energy_average and texture_energy_range were found to be the most important features in differentiating seborrheic keratosis from melanoma. Over-all, the seborrheic keratosis images were better identified by the texture features than the melanoma images.     

NB-UVB治疗儿童白癜风诱发脂溢性角化病一例

UVB治疗白癜风的不良反应主要有局部出现轻度瘙痒、红斑、光毒反应,儿童白癜风在接受NB-UVB治疗后,皮损区域出现脂溢性角化样的改变既往尚未报道。本文报道一例13岁右下肢屈侧白癜风女性患者,予31次NB-UVB照射治疗后局部出现褐色斑丘疹,组织病理学特点符合脂溢性角化病改变。     

日光性雀斑样痣、脂溢性角化病及扁平苔藓样角化病皮肤镜特征专家共识

【摘要】 日光性雀斑样痣、脂溢性角化病及扁平苔藓样角化病是常见的良性表皮增生性疾病,其皮肤镜特征对于明确诊断、与其他皮肤肿瘤相鉴别、避免不必要的活检和手术以及动态监测皮损变化等都有一定帮助。本共识对这3种疾病的皮肤镜特征进行了总结。日光性雀斑样痣的皮肤镜特征主要为皮损边界清晰、虫蚀状边缘、模糊的色素网、指纹模式、棕色均质模式、假性网络。脂溢性角化病的皮肤镜特征主要为皮损边界清晰、粟粒样囊肿、粉刺样开口、脑回状模式、发夹样血管、摇晃试验中皮损整体移动。扁平苔藓样角化病的皮肤镜特征主要为胡椒粉样或颗粒模式以及周围可见日光性雀斑样痣、脂溢性角化病或光线性角化病的皮肤镜特征。     

脂溢性角化病231例临床及病理分析

脂溢性角化病是一种常见病，但临床上易与多种疾病相混淆，通过对西京医院皮肤科门诊1990年－2000年252例脂溢性角化病的临床及病理资料进行回顾分析，发现脂溢性角化病临床和病理诊断符合率仅为69．44％，结果显示：（1）脂溢性角化病可发生于任何年龄；（2）黑色丘疹性皮病不应看作独立疾病，而是早期发生的脂溢性角化病。     

Ungual seborrheic keratosis

Background/Objectives Seborrheic keratoses are ubiquitous benign epithelial skin tumours. A number of unusual locations have already been reported. We report herein the case of a seborrheic keratosis of the nail bed with typical histological features. Methods/Results A 58‐year‐old man presented with a 1‐year‐history of longitudinal leukoxanthonychia of the right hallux. Surgical treatment was performed. The diagnosis of typical seborrheic keratosis of the nail bed was made on histological examination. Conclusion To our knowledge, this is the first report of a typical, histologically documented seborrheic keratosis of the nail bed. Therefore, this condition should be added to the differential diagnosis of acquired longitudinal leukoxanthonychia. However, surgical treatment remains necessary to rule out other causes, including squamous cell carcinoma.     

A poroid neoplasia arising close to a seborrheic keratosis and a trichoepithelioma.

A 69-year-old woman had a well-defined, slightly raised, brownish, keratotic plaque with an eccentric group of roughly circular, bluish, dome nodules on her right scapular area. Histological study revealed the presence of an eccrine poroma demonstrating features of eccrine poroma, hidroacanthoma simplex, and dermal duct tumor and arising in a lesion of seborrheic keratosis and a trichoepithelioma. In the eccrine poroma region, an area with malignant changes was evident. The findings in this case support the view of eccrine poroma as a spectrum of histological variants and the possibility of malignant transformation from a eccrine poroma towards porocarcinoma. The association with seborrheic keratosis is most probably coincidental, and the trichoepithelioma was probably due to induction of the tumoral stroma on adjacent follicular epithelia.     

Giant Seborrheic Keratosis on the Frontal Scalp Treated with Topical Fluorouracil

Giant seborrheic keratosis was observed on the frontal scalp of a 44-year-old man. The lesion was successfully treated with topical fluorouracil.     

液氮冷冻与Q开关激光治疗脂溢性角化病的疗效比较

目的:比较液氮冷冻与Q开关激光治疗脂溢性角化病的临床疗效.方法:选取2017年6月至2020年2月间我科就诊的脂溢性角化病患者,随机分为液氮冷冻组和Q开关激光治疗组.结果:共治疗170例患者,其中液氮冷冻组85例245枚皮损痊愈238枚(97.14％),显效7枚(2.86％),总有效率为100％,治疗后6个月继发性色素...