Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York 10016, USA.
J Am Acad Dermatol. 2013 Sep;69(3):426-30. doi: 10.1016/j.jaad.2013.03.035. Epub 2013 May 10.
There is no known association between the development of keratoacanthomas and prurigo nodules.
We report a case series of 7 patients with a long-standing history of actinic damage, pruritus, and prurigo nodularis who developed widespread keratoacanthomas within the same affected area.
This was a retrospective case series assessing the clinical characteristics of patients with multiple keratoacanthomas arising in association with prurigo nodules.
All 7 patients were elderly Caucasian women (mean age 79 ± 3.7 years) with actinically damaged skin and a long-standing history of widespread pruritus and prurigo nodules. All patients had histologically confirmed keratoacanthomas, or squamous cell carcinomas with the clinical appearance of a keratoacanthoma, that developed within the field of prurigo nodules. All 7 patients had a clinical response to acitretin with a decrease in the number of lesions. Four patients had an associated eczematous dermatitis and were also treated with cyclosporine with improvement in pruritus and prurigo nodules and no increase in keratoacanthomas.
The retrospective design and small number of patients are limitations to this study.
Our case series represents a distinct subset of elderly individuals with extensive actinic damage who we believe are predisposed to developing both prurigo nodules and keratoacanthomas.
目前已知的角状丘疹与痒疹结节之间并无关联。
我们报告了 7 例长期存在光损伤、瘙痒和痒疹结节病史的患者，他们在同一受累区域内广泛出现角状丘疹。
这是一项回顾性病例系列研究，评估了与痒疹结节相关的多发性角状丘疹患者的临床特征。
7 例患者均为老年白种女性（平均年龄 79 ± 3.7 岁），皮肤光损伤，长期广泛瘙痒和痒疹结节。所有患者均有组织学证实的角状丘疹，或表现为角状丘疹的鳞状细胞癌，这些病变均发生在痒疹结节的部位。7 例患者均对阿维 A 有临床反应，病变数量减少。4 例患者伴有湿疹性皮炎，也接受了环孢素治疗，瘙痒和痒疹结节得到改善，角状丘疹无增加。
本研究的局限性在于回顾性设计和患者数量少。
我们的病例系列代表了一组具有广泛光损伤的老年个体，我们认为他们容易同时发生痒疹结节和角状丘疹。
