Kono T, Kobayashi H, Ishii M, Nishiguchi S, Taniguchi S
Department of Dermatology, Osaka City University Medical School, 1-4-3, Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
J Am Acad Dermatol. 2000 Nov;43(5 Pt 2):966-8. doi: 10.1067/mjd.2000.103265.
Immunosuppression and transplantation have been reported to induce porokeratosis (PK), especially its variant, disseminated superficial PK (DSP). On the other hand, there is ample evidence of a relationship between hepatitis C virus (HCV) infection, liver cirrhosis (LC), and hepatocellular carcinoma (HCC). We report 3 cases of DSP in which the outbreak of DSP was suspected to have occurred during the development of HCC in patients with HCV-positive LC. The patients had undergone ultrasonographic study regularly, and no signs of malignancy had been found before the development of DSP. Their outbreaks of DSP were very acute, and the period between the development of DSP and diagnosis of HCC ranged from 2 to 6 months. The association of HCV-related HCC and DSP has never been previously reported. HCV-induced immunomodulation or its effect on the p53 system may be the basis for this type of association. It is necessary to consider development of HCC whenever DSP is found in HCV-positive patients. DSP may be a new paraneoplastic dermadrome.
据报道，免疫抑制和移植可诱发汗孔角化症（PK），尤其是其变种——播散性浅表性汗孔角化症（DSP）。另一方面，有充分证据表明丙型肝炎病毒（HCV）感染、肝硬化（LC）和肝细胞癌（HCC）之间存在关联。我们报告3例DSP病例，其中DSP的发作疑似发生在HCV阳性LC患者发生HCC的过程中。这些患者定期接受超声检查，在DSP发作之前未发现恶性肿瘤迹象。他们的DSP发作非常急性，DSP发作与HCC诊断之间的时间间隔为2至6个月。此前从未报道过HCV相关HCC与DSP的关联。HCV诱导的免疫调节或其对p53系统的影响可能是这种关联的基础。当在HCV阳性患者中发现DSP时，有必要考虑HCC的发生。DSP可能是一种新的副肿瘤性皮肤病综合征。
