Enhanced cytoplasmic expression of desmocollin 3 in epidermal rete ridges of Dowling–Degos syndrome
Enhanced cytoplasmic expression of desmocollin 3 in epidermal rete ridges of Dowling–Degos syndrome
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DOI：
10.1111/j.1365-2133.2003.05676.x
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发表时间：
2003-12
影响因子：
10.3
通讯作者：
Y‐C. Kim;M‐G. Lee;S‐H. Cho;J‐H. Lee;D‐H. Lee;B‐K. Ahn
中科院分区：
文献类型：
--
作者：
Y‐C. Kim;M‐G. Lee;S‐H. Cho;J‐H. Lee;D‐H. Lee;B‐K. Ahn
色素性鳞状细胞癌（PSCC）是一种非常罕见的SCC变体。迄今为止，只有24例PSCC病例在英语文献中报道。最近，发光显微镜（ELM）在诊断此类色素性皮肤病变方面带来了一些好处。我们报告的情况下，PSCC和描述ELM的结果，以前没有被报道。患者男，91岁，面部及双手多发结节、斑块。黑褐色角质结节和斑块出现在这些地区约13年前，并逐渐扩大和增加无症状。7年前，他的手背上的增生性斑块被手术切除，组织学诊断为SCC。他从事农业工作，几十年来一直暴露在阳光下。沿着在面部暴露于阳光的区域上观察到多发性、隆起、平坦、黑褐色至黄褐色角质结节的混合物，在他的左脸颊上观察到一个隆起、弹性坚硬、边界清楚、蜡黑色结节，直径6 mm，中央和边缘有微小的浅溃疡（图1A）。此外，在他的左鼻翼上发现一个隆起的、扁平的、弹性坚实的、边界清楚的、微黑的结节，直径为9 mm，被黄褐色至黑色的硬皮覆盖。未触及局部淋巴结。通过ELM，在脸颊上的病变中观察到灰棕色到石蓝色的结节状结构，其显示出界限分明的多环轮廓。尽管观察到相关溃疡导致的毛细血管扩张性细血管，但未观察到斑点、小球或截短的血管（图1B）。鼻部病变由被黄褐色至暗红色结痂覆盖的无结构区域组成。在切除3 mm切缘后的17个月内，没有发现复发或转移的证据。从组织学上看，这两个肿瘤都由形状不规则的巢组成，这些巢连接到邻近的表皮并延伸到真皮中部。巢包括角质轮，主要由非典型的鳞状细胞和一些有丝分裂的数字。树突细胞包括色素，
SIR, Pigmented squamous cell carcinoma (PSCC) is an extremely rare variant of SCC. Only 24 cases of PSCC have hitherto been reported in the English language literature. Epiluminescence microscopy (ELM) has recently brought some benefits in diagnosing such pigmented skin lesions. We report a case of PSCC and describe ELM findings which have not previously been reported. A 91-year-old man presented with multiple nodules and plaques on his face and bilateral hands. Blackish-brown keratinous nodules and erythematous plaques had appeared on these areas about 13 years previously, and had gradually enlarged and increased asymptomatically. Erosive erythematous plaques on his dorsal hands were surgically removed 7 years previously, and were histologically diagnosed as SCC. He had worked in agriculture and had been exposed to sunlight for several decades. Along with a mixture of multiple, elevated, flat, blackishbrown to yellowish-brown, keratinous nodules on sunexposed areas of the face, a mound-like, elevated, elastic-firm, well-demarcated, waxy-black nodule, measuring 6 mm in diameter, with tiny central and marginal shallow ulcers, was observed on his left cheek (Fig. 1A). In addition, an elevated, flat, elastic-firm, well-demarcated, blackish nodule, measuring 9 mm in diameter, covered by a yellow-brown to black crust, was noted on his left nasal ala. No regional lymph nodes were palpable. By ELM, grey-brown to slate-blue nodular structures which showed sharply demarcated, polycyclic outlines, were observed in the lesion on the cheek. There were no dots, globules or truncated vessels, although telangiectatic fine vessels due to the associated ulcer were noted (Fig. 1B). The nasal lesion consisted of a structureless area covered by yellow-brown to dark-red crusts. No evidence of recurrence or metastasis has been found for 17 months after removal with a 3-mm margin. Histologically, both tumours consisted of irregularly shaped nests which connected to the adjacent epidermis and extended to the mid-dermis. The nests included keratinous whorls, and were composed predominantly of atypical squamoid cells with some mitotic figures. Dendritic cells including pigments,