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突破复杂性：重度掌跖角化病的外科治疗

Cutting Through Complexity: Surgical Management of Severe Palmoplantar Keratoderma.

作者信息

Khan Muhammad Taimour, Amjad Ibrahim, Khan Muhammad Rahab

机构信息

Internal Medicine, Combined Military Hospital (CMH) Lahore Medical College and Institute of Dentistry, Lahore, PAK.

Plastic Surgery, AmjadPlastics, Miami, USA.

出版信息

Cureus. 2024 Jul 30;16(7):e65768. doi: 10.7759/cureus.65768. eCollection 2024 Jul.

DOI:10.7759/cureus.65768
PMID:39211646
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11361470/
Abstract

Olmsted syndrome is a rare genetic disorder characterized by severe thickening of the palms and soles, often resistant to conventional treatments. We present the case of a patient with Olmsted syndrome with a 16-year follow-up. The patient presented at five years of age with treatment-resistant palmoplantar keratoderma despite three years of dermatological management, leading to complications. Surgical interventions included initial debridement down to the deep dermis, which resulted in recurrence after three months. This was followed by a decision for extensive excision down to the subcutaneous tissue, use of a bilayer wound matrix dressing followed by negative pressure wound therapy, and a thin split-thickness graft, resulting in full resolution. The patient, now a college student, has regained normal daily activities. This case underscores the challenges and highlights a novel surgical approach for managing Olmsted syndrome, demonstrating a 16-year follow-up and aiming to improve patient outcomes in these complex cases.

摘要

奥姆斯特德综合征是一种罕见的遗传性疾病，其特征是手掌和脚底严重增厚，通常对传统治疗有抵抗性。我们报告一例奥姆斯特德综合征患者的16年随访情况。该患者5岁时就诊，尽管经过3年的皮肤科治疗，仍患有治疗抵抗性掌跖角化病，并引发了并发症。手术干预包括最初深达真皮层的清创术，但3个月后复发。随后决定进行深达皮下组织的广泛切除，使用双层伤口基质敷料，接着进行负压伤口治疗，并植入薄片断层皮片，最终完全治愈。该患者现已成为一名大学生，恢复了正常的日常活动。本病例强调了挑战，并突出了一种治疗奥姆斯特德综合征的新型手术方法，展示了16年的随访情况，旨在改善这些复杂病例的患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/beb0cc2fe5f2/cureus-0016-00000065768-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/b80ef9e5e18a/cureus-0016-00000065768-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/fd9a35f5933c/cureus-0016-00000065768-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/087e42042ee7/cureus-0016-00000065768-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/01e08ab2a594/cureus-0016-00000065768-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/706aa11442ac/cureus-0016-00000065768-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/cb668aefa29d/cureus-0016-00000065768-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/499b6c7acf9d/cureus-0016-00000065768-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/1b27d16c8e2a/cureus-0016-00000065768-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/99fd9e476e0a/cureus-0016-00000065768-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/beb0cc2fe5f2/cureus-0016-00000065768-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/b80ef9e5e18a/cureus-0016-00000065768-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/fd9a35f5933c/cureus-0016-00000065768-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/087e42042ee7/cureus-0016-00000065768-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/01e08ab2a594/cureus-0016-00000065768-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/706aa11442ac/cureus-0016-00000065768-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/cb668aefa29d/cureus-0016-00000065768-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/499b6c7acf9d/cureus-0016-00000065768-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/1b27d16c8e2a/cureus-0016-00000065768-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/99fd9e476e0a/cureus-0016-00000065768-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7163/11361470/beb0cc2fe5f2/cureus-0016-00000065768-i10.jpg

相似文献

1
Cutting Through Complexity: Surgical Management of Severe Palmoplantar Keratoderma.突破复杂性：重度掌跖角化病的外科治疗
Cureus. 2024 Jul 30;16(7):e65768. doi: 10.7759/cureus.65768. eCollection 2024 Jul.
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Olmsted syndrome.奥姆斯特德综合征
Indian J Dermatol. 2008;53(2):93-5. doi: 10.4103/0019-5154.41657.
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Proteolytic debridement of hyperkeratoses of palms and soles.手掌和足底角化过度的蛋白水解清创术。
AMA Arch Derm. 1958 Dec;78(6):758. doi: 10.1001/archderm.1958.01560120078012.
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Mutilating palmoplantar keratoderma with periorificial keratotic plaques (Olmsted's syndrome).伴有口周角化性斑块的残毁性掌跖角化病（奥姆斯特德综合征）。
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Palmoplantar keratoderma and skin grafting: postsurgical long-term follow-up of two cases with Olmsted syndrome.掌跖角化病与皮肤移植：两例奥姆斯特德综合征患者术后长期随访
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本文引用的文献

1
Diagnosis and Management of Inherited Palmoplantar Keratodermas.遗传性掌跖角化症的诊断与治疗。
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Tylosis with oesophageal cancer: Diagnosis, management and molecular mechanisms.伴食管癌的掌跖角化病：诊断、管理及分子机制
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Generic and personalized RNAi-based therapeutics for a dominant-negative epidermal fragility disorder.基于通用和个性化 RNAi 的治疗药物，用于治疗显性遗传性皮肤脆弱症。
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Keratosis palmaris et plantaris and its surgical treatment.掌跖角化病及其手术治疗
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Symmetrical palmo-plantar keratodermia and its treatment by plastic surgery (podoplantoneoplasty).对称性掌跖角化病及其整形外科治疗（足跖成形术）。
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Plantar keratodermia treated by split-skin grafts.采用分层皮片移植治疗足底角化病。
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