Park Michael, Boone Barbara, Devos Steven
Michael Park, MD Karel Janssenslaan 41, 8400 Oostende Belgium;
Acta Dermatovenerol Croat. 2014;22(2):150-4.
Xanthoma disseminatum is a non-familial disorder of non-Langerhans cell origin or a class II histiocytosis with unknown etiology, with just over 100 cases reported in the literature. Because of the rarity of this disease, there is no established treatment. We studied clinical manifestations and different treatments of xanthoma disseminatum from a series of cases, including our own patient. We studied 15 articles on treatment of xanthoma disseminatum. Local treatment with cryotherapy, radiotherapy, surgery, and carbon dioxide lasers have been attempted with various results. Systemic medication with peroxisome proliferator-activated gamma receptors, statins, fenofibrate, chlorodeoxyadenosine, cyclophosphamide, doxycycline, and cyclosporine have also been reported, but none have proven particularly successful. Xanthoma disseminatum is usually benign and is often self-limiting. If the lesions are accessible to surgery, that is likely to give the best results. However, if the lesions are not accessible for surgical removal then carbon dioxide laser treatment may be considered. The choice of oral treatment should be made on the basis of the patient's condition, since none of them have proven particularly effective. Expectant management is justifiable as long as the lesions are limited to the skin.
播散性黄瘤是一种非朗格汉斯细胞起源的非家族性疾病,或病因不明的II类组织细胞增生症,文献报道的病例仅100多例。由于这种疾病罕见,尚无既定的治疗方法。我们从一系列病例(包括我们自己的患者)中研究了播散性黄瘤的临床表现和不同治疗方法。我们研究了15篇关于播散性黄瘤治疗的文章。尝试过冷冻疗法、放射疗法、手术和二氧化碳激光等局部治疗,结果各不相同。也有报道使用过氧化物酶体增殖物激活γ受体、他汀类药物、非诺贝特、氯脱氧腺苷、环磷酰胺、强力霉素和环孢素等全身用药,但均未证明特别成功。播散性黄瘤通常是良性的,且往往具有自限性。如果病变适合手术切除,手术可能会取得最佳效果。然而,如果病变无法进行手术切除,则可考虑二氧化碳激光治疗。口服治疗的选择应根据患者的病情做出,因为这些治疗均未证明特别有效。只要病变局限于皮肤,观察等待是合理的。