Carranza Dafnis C, Haley Jennifer C, Chiu Melvin
Division of Dermatology, University of California Los Angeles, Los Angeles, CA 90095, USA.
Skinmed. 2008 Jan-Feb;7(1):51-2. doi: 10.1111/j.1540-9740.2007.07249.x.
A 34-year-old man from El Salvador was referred to our clinic with a 10-year history of a pruritic erythematous facial eruption. He reported increased pruritus and scaling of lesions when exposed to the sun. He worked as a construction worker and admitted to frequent sun exposure. Physical examination revealed well-circumscribed erythematous to violaceous papules with raised borders and atrophic centers localized to the nose (Figure 1). He did not have lesions on the arms or legs. He did not report a family history of similar lesions. A biopsy specimen was obtained from the edge of a lesion on the right ala. Histologic examination of the biopsy specimen showed acanthosis of the epidermis with focal invagination of the corneal layer and a homogeneous column of parakeratosis in the center of that layer consistent with a cornoid lamella (Figure 2). Furthermore, the granular layer was absent at the cornoid lamella base. The superficial dermis contained a sparse, perivascular lymphocytic infiltrate. No evidence of dysplasia or malignancy was seen. These findings supported a diagnosis of porokeratosis. The patient underwent a trial of cryotherapy with moderate improvement of the facial lesions.
一名来自萨尔瓦多的34岁男子因面部瘙痒性红斑疹10年病史转诊至我们诊所。他报告说，暴露在阳光下时，病变部位的瘙痒和脱屑会加重。他是一名建筑工人，承认经常暴露在阳光下。体格检查发现，鼻子上有边界清晰的红斑至紫蓝色丘疹，边界隆起，中央萎缩（图1）。他的手臂和腿部没有病变。他没有报告类似病变的家族史。从右鼻翼病变边缘取了活检标本。活检标本的组织学检查显示表皮棘层增厚，角质层有局灶性内陷，该层中央有均匀的角化不全柱，与鸡眼样板一致（图2）。此外，鸡眼样板底部无颗粒层。浅表真皮有稀疏的血管周围淋巴细胞浸润。未见发育异常或恶性病变迹象。这些发现支持汗孔角化症的诊断。患者接受了冷冻治疗试验，面部病变有中度改善。
