阴囊双蒂皮瓣联合皮片移植治疗男性外阴大面积乳房外Paget病

我院近期诊治26例外阴大面积乳房外Paget病(extramammary Paget's disease,EMPD),采用以阴囊双蒂皮瓣为主、联合皮片移植的方法修复缺损,取得较好的疗效. 一、临床资料 26例均经病理检查确诊为EMPD,均为男性,年龄54～73岁,平均63.2岁.皮损累及阴囊、阴茎、阴阜、下腹部12例,累及阴囊、阴茎、阴阜、腹股沟9例,累及阴囊、阴茎、阴阜、下腹部、腹股沟5例;皮损面积8cm× 10cm～9.5cm×11 cm;阴茎皮损面积占阴茎包皮面积的60％～90％.     

腋窝与阴茎的Paget病

患者,71岁,男性。阴茎茎部腹面,为姆指大红褐色斑片,右腋窝有黄豆大、境界明显,表面呈萎缩状红斑,皮下有硬结可触知。两处皮损病理切片检查:显示表皮内可见散在性或成堆的 Paget 细胞,此种细胞体积大、无胞突。胞浆丰富而淡染、核周较密。确诊后即在病灶边缘离开2cm 处作全切除术。     

手术联合光动力治疗累及阴茎的乳房外Paget病一例

<正>临床资料患者,男,65岁。主因外阴红斑伴痒痛6年,于2014年11月21日就诊。6年前,无明显诱因患者左侧阴囊皮肤出现一绿豆大疖肿样皮损并化脓,自行处理并好转后于原部位出现瘙痒性红斑,逐渐向周围扩大,偶有渗出、结痂,时有轻度瘙痒、辣痛感,反复搔抓后红斑处糜烂;于多家医院按湿疹予外用药治疗(具体不详),症状可稍缓解,但皮损从未完全消退,渗出与干涸交替。红斑渐向周围扩大,逐渐累及     

微小皮片移植治疗稳定期白癜风

国外报道采用微小移植治疗稳定期白癜风取得良好疗效[1].我们根据文献报道,进行改良后提出采用微小皮片移植治疗稳定期白癜风,取得较满意的疗效,现报道如下.     

全厚皮片游离移植治疗大面积色素痣

目的探讨全厚皮片游离移植治疗大面积色素痣的手术疗效及优势。方法 2001年6月~2009年6月,采用耳后或上臂内侧全厚皮片游离移植治疗大面积色素痣52例,男21例,女31例,年龄11岁~37岁;色素痣直径(长轴)30mm~90mm。结果本组患者共52例,22例行耳后皮片移植,30例行上臂内侧皮片移植。所有患者色素痣完全切除,植皮全部成活。术后随访3个月~2年,形态、功能良好,无并发症,效果满意。结论全厚皮片游离移植治疗大面积色素痣手术简单易行、适应症广、疗效较好,是比较理想的方法 。     

Paget病1例

Ｐａｇｅｔ病１例李恒进解放军总医院皮肤科（邮政编码１００８５３）患者女。５０岁，农民。４年前左乳头无明显诱因出现数个小米粒大红色丘疹，轻度病痒，随之破溃、糜烂、结痴，无疼痛。此后病情经常反复，皮损逐渐增大，扩及整个乳晕区。在当地医院按“湿疹”治疗，给...     

24例阴囊Paget病的治疗

我院1996年7月—2007年1月收治24例阴囊Paget患者,现将临床资料报告如下。1资料与方法1.1临床资料24例患者,年龄53～74岁,平均60岁。1例病人为油漆厂     

Paget病1例

1.临床资料 患者女,57岁.左侧乳房红斑及糜烂7年.7年前无明显诱因患者左乳晕出现红斑,上覆少量鳞屑,无明显瘙痒和疼痛.患者反复撕脱鳞屑后,红斑逐渐向周围扩大,并出现糜烂、渗液和结痂.自觉有轻微瘙痒和疼痛.曾在外院按"湿疹"治疗(具体用药不详),未见好转,糜烂和渗出仍然反复出现.4年前乳头消失,红斑继续向周围缓慢扩大.乳房始终未扪及肿块.既往体健,否认有家族遗传病史.     

乳房Paget病1例

患者女,68岁,已婚,因右侧乳头反复糜烂、渗出、结痂1年余,2011年6月12日就诊。患者2010年6月全身按摩后,发现右侧乳头皮肤破损,渐出现暗红色斑片,糜烂、渗出,     

阴囊Paget病1例

临床资料 患者男,71岁.右侧阴囊红斑、糜烂、结痂1年.1年前无明显诱因右侧阴囊出现片状红斑,轻微瘙痒.来我院就诊,真菌镜检阴性,诊断为＂湿疹＂,外用肤康王、复方地塞米松霜等治疗,无明显改善,皮疹逐渐增大,中央出现糜烂、结痂.既往体健,无慢性系统性疾病,无长期特殊化学物质及放射性物质接触史.     

Extramammary Paget's disease involving the penis, scrotum and the axilla

A 57-year-old man with a 2-year history of extramammary Paget's disease of the penis, scrotum and the axilla attended our urology clinic. The lesion in the axilla had been noticed 14 months later than the lesion involving the penis and scrotum. We performed a resection of both local extramammary Paget's disease lesions with a 3-cm margin. Intraoperative frozen sections were also used to ascertain clear surgical margins. Neither signs of recurrence nor underlying internal malignancy has developed after 2-year follow up. From our experience, extramammary Paget's disease may occur in multiple sites. In the absence of metastatic disease and underlying internal malignancy, a wide excision is recommended in the management of multiple lesions of extramammary Paget's disease.     

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。     

Benign mucinous metaplasia of the penis. A lesion resembling extramammary Paget's disease

Benign mucinous metaplasia in the surface epithelium of the genital area is rare and has only been reported once in the vulva. A unique case of benign mucinous metaplasia of the prepuce in a 65-year-old man is reported here. The lesion measured 0.6 cm, was located in the mucous surface of the foreskin, and showed acid mucin containing cells. We regard benign mucinous metaplasia as a reactive rather than a neoplastic process. The main lesions to be considered in the differential diagnosis are mucinous syringometaplasia, extramammary Paget's disease, cutaneous squamous cell carcinoma in situ with mucinous metaplasia, superficial spreading malignant melanoma, and epidermotropic metastasis. The confinement of mucin-containing cells to the epidermis, the absence of nuclear atypia, the basal orientation of the nuclei, the predominant location of the cells in the upper layers of the epithelium, and the fact that the mucinous cells are replacing the squamous epithelium rather that infiltrating it, all assist in recognizing mucinous metaplasia of the penis as a specific and benign entity.     

Photodynamic therapy for the treatment of extramammary Paget's disease

BACKGROUND: Surgical and ablative treatment modalities for extramammary Paget's disease (EMPD) have high recurrence rates and can be associated with significant morbidity. OBJECTIVES: To evaluate photodynamic therapy (PDT) for the treatment of EMPD. METHODS: We conducted a retrospective review of notes and histology of five men with anogenital, groin and axillary EMPD treated with PDT at Roswell Park Cancer Institute between 20 April 1995 and 1 February 2001. RESULTS: Sixteen EMPD lesions were treated with topical aminolaevulinic acid (ALA)-PDT. Eleven of these lesions had failed previous Mohs micrographic surgery, excision or laser ablation. When evaluated 6 months after one treatment with ALA-PDT, eight of 16 (50%) sites achieved a complete clinical response (CR); six of eight CRs were in lesions that had failed prior conventional therapies. Three of the eight CRs (37.5%) recurred at 9, 10 and 10 months. One patient who was partially responsive to topical ALA-PDT subsequently received systemic Photofrin(R)-PDT, with a complete clinical and histological response at 1 year. Functional and cosmetic outcome was excellent in all patients. CONCLUSIONS: PDT is an effective treatment for EMPD. Recurrence rates are high with topical ALA-PDT, but comparable with standard therapies. Topical ALA-PDT causes little scarring and is preferred for superficial disease and mucosal surfaces. Systemic Photofrin(R)-PDT may be better suited for bulky disease. While further studies are indicated, PDT is well tolerated and appears to be a useful therapy for EMPD.     

An unusual case of extramammary Paget's disease. Paget's disease of the glans penis probably originating from a prostatic duct carcinoma (transitional cell carcinoma of the prostate)

A patient, having been treated by total cystectomy and Bricker's conduit operation for prostatic duct carcinoma with intraepithelial extension into the prostatic urethra and bladder, developed an annular, psoriasiform eruption around the external orifice of the urethra two and one-half years later. A biopsy of this lesion showed pagetoid changes of the epidermis. Microscopic examination of the surgical specimen, consisting of the glans penis and corpus spongiosum, demonstrated intraepithelial-tumor permeation into the glans penis, penile urethra, and periurethral glands (Littre). It seems reasonable to conclude that this is an unusual case of Paget's disease of the glans penis which probably originated from a prostatic duct carcinoma.