Boyd Alan S, Su Pei F, Shyr Yu, Tang Yi W
Department of Medicine (Dermatology), Vanderbilt University, Nashville, TN, USA; Department of Pathology, Vanderbilt University, Nashville, TN, USA.
Int J Dermatol. 2014 Nov;53(11):1346-50. doi: 10.1111/ijd.12086. Epub 2014 Jun 5.
Seborrheic keratoses (SK) are the most common cutaneous neoplasm in humans. Given their numbers, a squamous cell carcinoma in situ (SCCIS) arising from an SK would not be unexpected, although this occurrence has not been widely reported.
This study compares the immune status of patients with a SCCIS arising contiguously from SK (SK/SCCIS) and the number of daily medications taken by these patients. The biopsy tissue was evaluated for the presence of human papillomavirus DNA.
Over a 5-year period at our institution, 13 cases of SK/SCCIS were diagnosed. For each case, age- and sex-matched control patients with a histologically diagnosed unremarkable SK were randomly selected. The number of patients taking immunosuppressing medications was determined from each group and compared statistically. In addition, polymerase chain reaction analysis of the 13 SK/SCCIS biopsies was performed.
Five of the 13 study patients took immunosuppressive medications compared to none of the 39 control patients (P = 0.0005). None of the biopsies demonstrated the presence of human papillomavirus DNA by polymerase chain reaction.
Immunocompromised patients with SKs appear to carry a greater risk of these otherwise innocuous lesions developing an SCCIS, although given the small number of patients evaluated, further research into this possible association is warranted.
脂溢性角化病（SK）是人类最常见的皮肤肿瘤。鉴于其数量众多，由SK发展而来的原位鳞状细胞癌（SCCIS）并非意外情况，尽管这种情况尚未被广泛报道。
本研究比较了由SK连续发展而来的SCCIS患者的免疫状态以及这些患者每日服用药物的数量。对活检组织进行人乳头瘤病毒DNA检测。
在我们机构的5年时间里，共诊断出13例SK/SCCIS病例。对于每一例病例，随机选择年龄和性别匹配、经组织学诊断为无异常的SK对照患者。确定每组服用免疫抑制药物的患者数量并进行统计学比较。此外，对13例SK/SCCIS活检组织进行聚合酶链反应分析。
13例研究患者中有5例服用免疫抑制药物，而39例对照患者中无一例服用（P = 0.0005）。聚合酶链反应分析显示，活检组织中均未检测到人乳头瘤病毒DNA。
免疫功能低下的SK患者发生SCCIS的风险似乎更高，尽管本研究评估的患者数量较少，但仍有必要对这种可能的关联进行进一步研究。
