Blum A, Hartmann K W, Rütten A
Hautarztpraxis, Konstanz, Deutschland.
Hautarzt. 2010 Jan;61(1):64-8. doi: 10.1007/s00105-009-1885-z.
Pigmented Paget disease of the nipple is a rare disease. We report on a 60-year-old woman in whom this diagnosis was made based on clinical findings, dermoscopy, histology and immunohistology. Circumscribed pigmentation of the nipple includes a wide spectrum of benign and malignant differential diagnostic considerations. Dermoscopy can enhance the clinical diagnosis. Biopsies should always be performed on unclear pigmentation of the nipple in both women and men. On histology, rare melanocytic tumors must be differentiated from pigmented Paget disease and pigmented Bowen disease. Pagetoid intraepithelial cells of a melanocytic tumor are positive for S100, HMB45 or melan A, but not for cytokeratins. Intraepithelial tumor cells of Paget disease are positive for cytokeratin 7. The clear cells in Bowen diseases are usually not positive for cytokeratin 7 and are also negative for all melanocytic markers.
乳头色素沉着性佩吉特病是一种罕见疾病。我们报告了一名60岁女性，其诊断基于临床发现、皮肤镜检查、组织学和免疫组织学。乳头的局限性色素沉着包括一系列广泛的良性和恶性鉴别诊断考虑因素。皮肤镜检查可提高临床诊断准确性。无论男女，乳头色素沉着情况不明时均应进行活检。在组织学上，罕见的黑素细胞肿瘤必须与色素沉着性佩吉特病和色素沉着性鲍恩病相鉴别。黑素细胞肿瘤的佩吉特样上皮内细胞对S100、HMB45或黑素A呈阳性，但对细胞角蛋白呈阴性。佩吉特病的上皮内肿瘤细胞对细胞角蛋白7呈阳性。鲍恩病中的透明细胞通常对细胞角蛋白7不呈阳性，并且对所有黑素细胞标记物也呈阴性。
