右拇指甲下鳞状细胞癌

报告1例右拇指甲下鳞状细胞癌。患者男,80岁。右手拇指疼痛并逐渐出现指甲变形、增厚及发黄1年。皮肤科检查:右手拇指指甲远端及外侧缘甲剥离,叠层状碎裂,指甲及手指皮肤稍增厚发黄,甲板下境界清楚的黄棕色红色肿物。甲下组织病理检查:鳞状上皮增生,向真皮呈浸润性生长,细胞排列紊乱有异形,可见核分裂像。诊断:甲下鳞状细胞癌。     

甲下鳞状细胞癌1例

患者男，50岁，右手第4指甲下肿物伴糜烂3年，既往银屑病史20余年。查体：右手第4指甲下黄豆大小红色肿物，表面糜烂伴少量渗液。皮损组织病理示：与表皮相连的鳞状细胞向真皮内浸润生长，细胞异型性，核分裂象增加。病理诊断：甲下鳞状细胞癌。治疗上予局部组织切除。     

压力性溃疡误诊为鳞状细胞癌

压力性溃疡误诊为鳞状细胞癌田衍荣青岛市市立医院皮肤科（邮政编码２６６０１１）患者男，５３岁。５个月前酒后醉眠２０ｈ，醒时左臀部发生一红色斑片，历４天局部变黑，形成溃疡。当地医院病理诊断鳞状细胞癌（ＳＣ），住院４３天放疗总剂量为７０００ＣＧＹ，未好转。...     

棘层松解性鳞状细胞癌一例

棘层松解性鳞状细胞癌又名假腺样鳞状细胞癌、腺样鳞状细胞癌,它是鳞状细胞癌组织病理学上的一种亚型,多见于老年人的面部、耳部、手背等暴露部位,也可发生于口腔、眼结膜及外阴等部位。本文报道1例成功手术治疗高危老龄患者的棘层松解性鳞状细胞癌。临床资料患者,男,91岁。主因右侧颞部肿物3年,于2014年6月18日就诊。患者3年前无明显诱因于右颞部出现甲盖大小红斑,反复破溃、出血、结痂,常     

皮肤鳞状细胞癌13例临床诊治体会

目的探讨皮肤鳞状细胞癌的临床表现,组织病理及诊治。方法对13例临床拟诊为皮肤鳞状细胞癌的患者,组织病检确诊后,采取外科手术,高频电离子治疗。结果 13例患者均经组织病理检查证实为皮肤鳞癌,其中2例放弃治疗,2例行高频电离子治疗,9例行手术治疗。对治疗后的11例患者分别随访1月～16年,患者均健在,病灶无转移。结论鳞状细胞癌是一种恶性肿瘤,早期发现,早期诊断,早期治疗是提高生存率的关键。     

皮肤鳞状细胞癌研究进展

近年来的资料分析表明,皮肤鳞状细胞癌发病率有逐年增高趋势,尤其在老年人中。由于皮肤鳞状细胞癌在临床和组织病理学上的多样性,因而误诊的情况常见。有鉴于此,对近年来有关皮肤鳞状细胞癌在基础和临床方面的研究进展,诸如流行病学、病因和发病机制、临床类型和表现、诊断和鉴别诊断、新的治疗措施及其预防进行了综述,以期对皮肤鳞状细胞癌的早期诊断、治疗选择和预防有所帮助。     

光线性角化病159例与皮肤鳞状细胞癌51例临床病理特征分析

目的了解滇东地区光线性角化病与鳞状细胞癌的疾病构成比、一般情况和临床病理特征。方法采用回顾性研究方法对曲靖市第一人民医院皮肤科2014年1月-2018年12月共5年行病理检查确诊的光线性角化病和皮肤鳞状细胞癌患者的临床和病理检查资料进行分析。结果159例光线性角化病(AK)与51例(SCC)鳞状细胞癌患者中女性多于男性,光线性角化病和鳞状细胞癌的发病平均年龄分别为(66.32±14.63)岁和(65.00±16.26)岁。光线性角化病和鳞状细胞癌患者皮损发生于曝光部位的分别占98.11%和78.43%。51例鳞状细胞癌患者中,有3例均是光线性角化病继发鳞状细胞癌,均为女性,年龄均>70岁,发病部位均为曝光部位。5年确诊光线性角化病患者占总病检患者的构成比相对稳定,其中鳞状细胞癌有所波动。AK病理分型分为肥厚型98例(61.64%)、萎缩型26例(16.35%)、棘层松解型12例(7.55%)、色素型9例(5.66%)、苔藓样型9例(5.66%)、鲍温样型5例(3.14%);SCC病理分级Ⅰ级39例(76.47%)、Ⅱ级11例(21.57%)、Ⅲ级1例(1.96%)、Ⅳ级0例。光线性角化病与鳞状细胞癌中临床诊断与病理诊断符合率分别为61.00%和56.86%,易被误诊为其他疾病。结论滇东地区光线性角化病与鳞状细胞癌以中老年女性为主,主要位于头面颈部等曝光部位,与紫外线关系密切,其中发生于曝光部位、皮损多样、病程长的老年女性光线性角化病患者易继发鳞状细胞癌,但临床病理诊断符合率较低,需引起重视。     

41例皮肤基底细胞癌的临床病理及误诊分析

目的：分析总结41例皮肤基底细胞癌的临床病理特点及误诊情况。方法：对41例皮肤基底细胞癌的临床及病理资料进行回顾性分析。结果：41例皮肤基底细胞癌中,发病年龄中位数为59岁（34～82岁）,多发于头面部,共39例,占95．1％,通过组织病理检查,41例均证实为基底细胞癌。其中9例进行免疫组化标记示CK（＋）,S-100（-）。临床诊断为基底细胞癌24例,占58．5％,误诊为脂溢性角化4例,黑素细胞痣3例,鳞状细胞癌、黑素细胞瘤、寻常狼疮各2例,误诊为其他4例。结论：被误诊的皮肤基底细胞癌患者大多数年龄较大,病程缓慢,临床表现不典型。尽早行组织病理检查,并结合免疫组化标记进行识别,可提高皮肤基底细胞癌的诊断准确率。     

类着色性干皮病伴面部基底细胞癌及鳞状细胞癌1例

患者女,37岁。面部、躯干及四肢斑疹32年,面部黑色结节5年。两处面部黑色结节病理活检分别为基底细胞癌及鳞状细胞癌。诊断为类着色性干皮病伴发基底细胞癌及鳞状细胞癌。     

皮肤鳞状细胞癌的研究进展

近年来,皮肤鳞状细胞癌的发病率仍持续上升,且因其临床表现多样,容易误诊延误病情。鉴于此,该文对皮肤鳞状细胞癌流行病学、病因与发病机制、临床表现及组织病理、治疗及预后的研究进展进行综述,希望对皮肤鳞状细胞癌的早期诊断、治疗选择和预防有所帮助。     

Invasive squamous cell carcinoma after treatment of carcinoma in situ with 5% imiquimod cream

Squamous cell carcinoma in situ has the potential to progress to invasive squamous cell carcinoma. This report presents two cases of punch biopsy-proven squamous cell carcinoma in situ, treated with once-daily application of 5% imiquimod cream for 6 weeks. Both patients developed moderate local inflammatory reactions during treatment. The first patient demonstrated clinical clearance of the scalp lesion after treatment. Two months later, he re-presented with a subcutaneous nodule at the same site. Histology was consistent with recurrent squamous cell carcinoma. Five months following excision of the recurrent tumour, he presented with metastatic squamous cell carcinoma to a cervical lymph node. The second patient had low-grade chronic lymphocytic leukaemia and presented with squamous cell carcinoma in situ of the leg that failed to clear clinically after treatment with imiquimod. He presented 4 months later with a focus of invasive squamous cell carcinoma within the lesion.     

Bowen's diseases and basal cell carcinomas in a patient.

Bowen's disease is a well-known precancerous lesion, in which invasive squamous carcinoma may develop. However, it is rare that Bowen's disease, basal cell carcinoma, and internal malignancy develop in a single patient. We report a case of a 54-year-old male patient with Bowen's disease, basal cell carcinoma of the skin, and squamous cell carcinoma of the lung. Multiple scaly erythematous patches had developed several years earlier and were diagnosed as Bowen's disease by skin biopsy. The number of lesions increased and, five months ago, a right lower lobectomy was done for squamous cell carcinoma which was detected on a chest X-ray. Skin biopsies of two different sites revealed Bowen's disease and basal cell carcinoma. The arsenic level was increased in his hair specimen. Cryotherapy was applied.     

Pseudoangiosarcomatous squamous cell carcinoma of skin arising adjacent to decubitus ulcers

Pseudoangiosarcomatous, or pseudovascular, squamous cell carcinoma of skin is an unusual form of acantholytic (adenoid, pseudoglandular) squamous cell carcinoma that mimics the histolopathologic appearance of angiosarcoma. We report a case of pseudoangiosarcomatous squamous cell carcinoma arising adjacent to decubitus ulcers. The histopathologic examination of a wedge biopsy specimen revealed infiltrative cords of neoplastic cells that formed interanastomosing channels imitating angiosarcoma. Immunohistochemical staining was negative for the endothelial markers (CD31, CD34, and factor VIII-related antigen) and positive using cytokeratin antibodies (AE1/AE3 and 34 betaE12). Because of metastatic disease, palliative measures were undertaken and the patient died four months later. To our knowledge, our patient is the first with pseudoangiosarcomatous squamous cell carcinoma of skin developing within decubitus ulcer.     

泛发性扁平苔藓继发面部巨大鳞状细胞癌1例

报告1例泛发性扁平苔藓并发巨大鳞状细胞癌。患者男，20岁。因全身暗红色斑块10年，面部肿块5个月就诊。腹部皮损组织病理活检显示，符合扁平苔藓病理改变，面部肿块经病理诊断为中分化鳞状细胞癌。     

Eruptive keratoacanthoma and squamous cell carcinoma complicating imiquimod therapy: response to oral acitretin

An 87-year-old woman with eruptive keratoacanthomas complicating recent imiquimod therapy is presented. Lesions developed both at and distal to the treatment site. She responded well to 8 weeks of oral acitretin with resolution of most lesions and no recurrence at 6 months post treatment. A remaining lesion was excised and found to be a well-differentiated squamous cell carcinoma. Keratoacanthoma and squamous cell carcinoma should be considered in any patient developing rapidly growing keratotic nodules in association with recent imiquimod therapy. The aetiology and treatment of eruptive keratoacanthomas is briefly discussed.     

Subunguales Plattenepithelkarzinom

A 63-year-old patient presented with a 12-month history of a subungual tumor on the right middle finger. The patient had had a similar lesion involving his left index finger 5 years ago, which was identified as a subungual squamous cell carcinoma. Except for hypertension and hyperlipidemia, the patient was in good health. Ablation of the nail plate, the nailbed and the matrix was performed. Histopathology confirmed another subungual squamous cell carcinoma. The patient received a full thickness skin graft. Subungual squamous cell carcinomas are among the most frequently reported types of subungual malignancies. However, subungual squamous cell carcinomas arising in more than one digit have been reported only rarely. The cause of subungual squamous cell carcinoma has not been clearly identified. Subungual squamous cell carcinoma has been associated with radiation, chronic infection, arsenic ingestion, HPV infection and trauma. None of these could be identified in our patient.     

Successful treatment of multiple premalignant and malignant lesions in arsenical keratosis with a combination of acitretin and intralesional 5-fluorouracil

A case of arsenical keratosis with multiple lesions of Bowen's disease and squamous cell carcinoma is described. The patient was successfully treated with a combination of acitretin and intralesional 5-fluorouracil. All the lesions resolved after three months of therapy with no side effects and no recurrence during four months of follow-up.     

Parotideal lymph node metastasis in squamous cell carcinoma of the skin

BACKGROUND: Metastatic involvement of the parotideal lymph nodes from cutaneous squamous cell carcinoma is rare in occurrence, but has a high prognostic value. The aim of the present study was to define a patient group with a high risk for development of regional metastasis and to determine the follow-up course and therapy of metastasis in these patients. MATERIAL AND METHODS: Nineteen patients treated with malignancies of the parotid gland over a time period of four years were analyzed prospectively. RESULTS: In 6 out of 19 patients the parotideal tumor proved to be a lymph node metastasis of previously treated poorly differentiated squamous cell carcinoma of the skin. The diameter of the primary tumor was at least 1.5 cm in 5 out of 6 cases. The time interval between detection of metastatic involvement of the parotid gland and diagnosis of a preexisting skin cancer was approximately 7 months. Metastastic infiltration of cervical lymph nodes could be shown in 4 patients. In one patient pulmonary metastases were detected. CONCLUSION: On the basis of data from the literature and the results presented here, patients who are at high risk for regional metastasis were defined. Clinical examination of the parotid gland and cervical lymph nodes should be performed frequently in these patients at least for 18 months after primary tumor diagnosis. Parotideal lymph node metastases of a squamous cell carcinoma of the head skin should have similar treatment to primary squamous cell carcinoma of the parotid gland provided that a curative option exists.     

Squamous cell carcinoma arising on a skin graft 64 years after primary injury

Malignant degeneration of a chronic wound is often described by the term, Marjolin's ulcer. We present a case of a squamous cell carcinoma that developed in a patient 64 years after the initial injury during World War II. Tissue contusion and detachment required repeated surgery and full skin grafting in several hospitals. The patient had a persistent ulcer in the right popliteal region for the last 3 years. Excisional biopsy in our department showed a bifocal low-grade invasive squamous cell carcinoma of the skin. Because of extensive inflammation and previous scar formation it was difficult to determine the status of the surgical margins. Therefore, we proceeded with amputation at the right thigh. Some 6 months after surgery the general condition of the patient remains excellent.     

手术治疗面部皮肤恶性肿瘤

目的　探讨面部皮肤恶性肿瘤的手术及修复的临床经验。方法 2000年1月至2006年12月,收治面部皮肤恶性肿瘤65例,其中基底细胞上皮瘤47例,鳞状细胞癌10例,隆突性皮肤纤维肉瘤3例,恶性黑素瘤2例,棘皮瘤恶变、血管内皮肉瘤、皮脂腺癌各1例,均予扩大切除,术中作冰冻切片监测手术切缘及基底,分别采用直接缝合、邻位随意皮瓣、扩张皮瓣、游离皮片移植修复。结果 65例患者均一期修复,皮片和皮瓣100%存活,术区外形和功能满意。随访6个月至5年,基底细胞上皮瘤局部复发1例;鳞状细胞癌1例颈部淋巴结转移,1例局部复发;恶性黑素瘤1例去世,余无局部复发和转移。结论 彻底切除面部皮肤恶性肿瘤是预防术后复发的关键。适宜的修复有助于容貌恢复,其中以邻位随意皮瓣的效果较好。