CAJ | 학술논문

患儿女,13岁.3岁时无特殊诱因肘膝踝关节处突发粗糙肥厚斑块.因无自觉症状及其他不适,未予处理.此后皮损从未消退,亦未扩大.肘膝部损害上覆1 ～2mm角化性丘疹,损害群集成片,部分融合.踝关节处损害为环状角化性斑块.组织病理检查:表皮角化过度及轻度角化不全、毛囊角栓、棘层肥厚、真皮乳头增宽、乳头内毛细血管扩张、管周单个核细胞浸润,真皮浅层少许非特异性细胞浸润.根据患者的临床表现、皮损特点及组织病理检查结果,诊断为局限性角化病.予以维生素A口服、卤米松及尿素维E乳膏外用,15d后皮肤损害表面光滑,肥厚减轻,但停药1个月后,皮肤损害又呈粗糙肥厚样.
환인녀,13세.3세시무특수유인주슬과관절처돌발조조비후반괴.인무자각증상급기타불괄,미여처리.차후피손종미소퇴,역미확대.주슬부손해상복1 ～2mm각화성구진,손해군집성편,부분융합.과관절처손해위배상각화성반괴.조직병리검사:표피각화과도급경도각화불전、모낭각전、극층비후、진피유두증관、유두내모세혈관확장、관주단개핵세포침윤,진피천층소허비특이성세포침윤.근거환자적림상표현、피손특점급조직병리검사결과,진단위국한성각화병.여이유생소A구복、서미송급뇨소유E유고외용,15d후피부손해표면광활,비후감경,단정약1개월후,피부손해우정조조비후양.
A 13-year-old girl suddenly developed hypertrophic rough-surfaced plaques on both elbows, knees and ankles without obvious precipitating factors at 3 years of age.Because there was no subjective symptom or other discomfort, no treatment was given.Thereafter, the lesions neither faded nor spread.Skin examination revealed lesions covered with 1-2 mm-sized keratotic papules on the elbows and knees, which were clustered together and confluent in some areas.Circular keratotic plaques were observed on the ankles.Histopathology showed epidermal hyperkeratosis with mild parakeratosis, follicular keratotic plugs, acanthosis, broadened dermal papillae, telangiectasis and perivascular mononuclear infiltration in dermal papillae, infiltration of a few nonspecific cells in the superficial dermis.According to the clinical manifestations and histopathological findings, the patient was diagnosed with keratosis circumscripta, and treated with oral vitamin A and topical halometasone cream and urea-vitanmin E cream.The degree of skin hypertrophy and roughness was decreased after 15 days of treatment, but increased 1 month after drug withdrawal.