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243例鼻面部溃疡患者的临床回顾性分析

Clinical Retrospective Analysis of 243 Patients with Rhinofacial Ulcers.

作者信息

Ma Weiyuan, Zhan Ruyu, Sui Changlin, Zhou Fushan, Liu Haidong, Zhang Xiuwen, Ruan Zhenqiang, Wang Yukun, Cai Xiaolan

机构信息

Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China.

Scientific Research Center, Anxi County Hospital, Quanzhou, Fujian, People's Republic of China.

出版信息

Clin Cosmet Investig Dermatol. 2022 Aug 1;15:1475-1483. doi: 10.2147/CCID.S371029. eCollection 2022.

Abstract

PURPOSE

The clinical and pathological data of patients with rhinofacial ulcers were retrospectively reviewed and analyzed to lay the foundation for standardized clinical treatment.

PATIENTS AND METHODS

We retrospectively analyzed the clinical data, etiology, pathological features, treatment methods, and prognosis of 243 patients with rhinofacial ulcers treated in the Departments of Otorhinolaryngology and Dermatology at six hospitals in Shandong Province, China from July 2014 to October 2021. The clinical characteristics and treatment methods of the rhinofacial ulcers were summarized to provide a basis for standardizing patients' diagnosis and treatment.

RESULTS

The male-to-female ratio of the 243 patients was 2.04:1, and their ages ranged from 25 to 91 years. The most common sites were the cheek, nasal dorsum, and upper lip. The common primary diseases were basal-cell carcinoma, squamous-cell carcinoma, and odontogenic fistula, but rare triggers played important roles in some cases, such as infection, autoimmune diseases, and adverse drug reactions. Surgical treatment was feasible for tumor ulcers; 71 patients with basal-cell carcinoma and 50 with squamous-cell carcinoma were treated with Mohs micrographic surgery. During the follow-up period of 1-84 months, most of the rhinofacial ulcers were cured, while natural killer/T-cell lymphoma, angiosarcoma, and melanoma were important causes of death.

CONCLUSION

Various causes may lead to rhinofacial skin ulcers, and some cases lacking specificity of clinical manifestations are easily misdiagnosed in clinical practice. Histopathological biopsy is valuable for confirming the diagnosis, after which correct etiological treatment is very important.

摘要

目的

回顾性分析鼻面部溃疡患者的临床及病理资料,为规范临床治疗奠定基础。

患者与方法

回顾性分析2014年7月至2021年10月在山东省6家医院耳鼻咽喉科和皮肤科就诊的243例鼻面部溃疡患者的临床资料、病因、病理特征、治疗方法及预后。总结鼻面部溃疡的临床特点及治疗方法,为规范患者的诊断和治疗提供依据。

结果

243例患者男女比例为2.04∶1,年龄25~91岁。最常见部位为面颊、鼻背和上唇。常见原发病为基底细胞癌、鳞状细胞癌和牙源性瘘管,但在某些病例中,罕见诱因如感染、自身免疫性疾病和药物不良反应也起重要作用。肿瘤性溃疡可行手术治疗;71例基底细胞癌和50例鳞状细胞癌患者接受了莫氏显微外科手术治疗。在1~84个月的随访期内,大多数鼻面部溃疡治愈,而自然杀伤/T细胞淋巴瘤、血管肉瘤和黑色素瘤是重要死亡原因。

结论

多种病因可导致鼻面部皮肤溃疡,部分临床表现缺乏特异性的病例在临床实践中易被误诊。组织病理活检对确诊有重要价值,确诊后进行正确的病因治疗非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d55f/9355335/da0dfab0bd48/CCID-15-1475-g0001.jpg

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