Rémond B, Dompmartin A, Mandard J C, Leroy D
Service de Dermatologie, CHU, Caen.
Ann Dermatol Venereol. 1994;121(1):50-2.
Disseminated superficial actinic porokeratosis was first described by Chernosky and Anderson in 1969. It is characterized by multiple small keratotic lesions on sun-exposed areas beginning in the third of fourth decade. The development of a squamous cell carcinoma within lesions of porokeratosis or the association of superficial actinic porokeratosis with immunosuppression have been well documented. We report the case of a 68-year-old patient who presented actinic porokeratosis associated with rapidly evolutive squamous cell carcinoma of the leg. During the hospitalization, an IgA myeloma was discovered. The authors discuss the relationship between porokeratosis, immunosuppression, and squamous cell carcinoma. Pathogenesis of the lesions is interesting because it is admitted that a keratinocyte clone which carries the porokeratosis abnormality is going to proliferate because of immunosuppression, trauma and infectious diseases. It seems important to search for immunosuppression in patients presenting porokeratosis because the incidence of malignant transformation may increase.
播散性浅表性光化性汗孔角化症于1969年由切尔诺斯基和安德森首次描述。其特征为在第三或第四个十年开始时,在阳光暴露部位出现多个小角化性病变。汗孔角化症病变内发生鳞状细胞癌或浅表性光化性汗孔角化症与免疫抑制相关联,这些已有充分记录。我们报告一例68岁患者,其患有与腿部快速进展的鳞状细胞癌相关的光化性汗孔角化症。住院期间,发现了IgA骨髓瘤。作者讨论了汗孔角化症、免疫抑制和鳞状细胞癌之间的关系。病变的发病机制很有意思,因为人们认为携带汗孔角化症异常的角质形成细胞克隆会因免疫抑制、创伤和传染病而增殖。对于患有汗孔角化症的患者,寻找免疫抑制似乎很重要,因为恶性转化的发生率可能会增加。