epidermal dysplasia verrucous
Introduction
Introduction to sickle epidermal dysplasia Epidermodysplasia Verruciformis This disease, also known as the generalized flat wart, was first reported by Lewandowsky and Luts in 1922. First reported by Lewandowsky and Lutz in 1922, characterized by generalized flattened sputum-like lesions throughout the body, also known as sputum-like epidermal dysplasia. basic knowledge The proportion of illness: 0.003% Susceptible people: no special people Mode of infection: non-infectious Complications: edema
Cause
Causes of sickle epidermal dysplasia
Causes:
In the past, it was considered to be a hereditary disease, but this disease can be vaccinated by itself and allogeneic, and it is found by electron microscopy that there are papovavirus particles in the inclusions in the damaged nucleus, thus confirming that the disease is a generalized sputum. So far, HPV type 6 has been isolated from the rash, including types 3, 5, 8, 9, 10 and 12, but mainly HPV-3 and HPV-5. HPV-5 has carcinogenic potential. However, this disease Malignant lesions are only seen in the exposed areas, so some people think that sun damage is the main factor of malignant transformation, and prion may be only an additional factor, and at the same time related to the patient's special constitution.
Pathogenesis:
The disease is associated with a variety of human papillomavirus types, including HPV 3,5,8-10,12,14,15,17,19-25, of which HPV 3 is common in benign, generalized flattened lesions. In general, HPV 5 is not found in flat lesions, but is also found in the tinea versicolor type, which has the possibility of carcinogenesis. Skin cancer often occurs in the direct sunlight, causing the spotted sputum type. With HPV 8,9,12,15, most patients have impaired cellular immune function.
Prevention
Malignant epidermal dysplasia prevention
1. Keep away from ultraviolet light and ionizing radiation.
2. Keep away from traumatic treatments, such as ionization, laser, and autologous corpus callosum implantation. Such treatments tend to form "homotype reactions," which can cause scars that are difficult to remove and can aggravate the condition.
3. Stay away from hormonal drugs.
4. Drink plenty of water, eat more vegetables, fruits, and make fruit noodles.
5. Due to the family's genetic predisposition, the close relatives should be avoided and the prenatal and postnatal care should be promoted.
6. Because the damage caused by cancer is only seen in the exposed parts, patients should be warned to avoid sun exposure, such as wearing a hat, long trousers or external light-protecting agent.
7. Regular follow-up observation to prevent cancer.
Complication
Verrucous epidermal dysplasia Complications edema
The disease is chronic, a small number of patients can resolve by one to two years or more, and the basal part of the sputum often has an inflammatory reaction before it subsides. The itching is aggravated, but it can recur. Very few patients may have cancerous changes, although The carcass is removed, but the effect is not good, which causes many patients with edema, ulcers, sputum and other complications.
Symptom
Symptoms of sputum epidermal dysplasia common symptoms pimples freckles
The disease is usually young, but it can also be first developed at any age. The skin lesions can be divided into three types:
1 flat sputum type: the most common, the number of skin lesions is large and large, the single lesion is a flat scorpion-like papule from rice to soybean, round or polygonal, dark red, purple or brown, widely distributed, can be involved Most skin and mucous membranes.
2 piebald sputum type: less common, the skin lesions are lighter flattened papules, almost no higher than the skin, slightly keratinized.
3 point scar type: the most rare, mild skin depression, keratinization is also mild, skin lesions occur in the face, neck, trunk, limbs, can also spread the whole body, and even the lips, urethra can also occur small Symptoms, trunk and limb rash are relatively large and hard, and can exist for many years without change. About 20% of patients may develop squamous cell carcinoma or basal cell carcinoma, and in addition, they may be accompanied by palmar keratosis and nail changes. , freckles and mental retardation.
Examine
Examination of verrucous epidermal dysplasia
Histopathology: hyperkeratosis of the epidermis, hypertrophy of the acanthus, formation of vacuoles in the granular layer and acanthosis cells, and formation of a basket-like shape. Although the cytoplasm is completely melted and vacuolated, the nucleus still exists, and there are no keratinized cells.
Diagnosis
Diagnosis and differentiation of sickle epidermal dysplasia
diagnosis
According to the clinical manifestations and pathological examination of generalized flat sputum lesions, it can be diagnosed, and can be used for electron microscopy and PCR detection for further diagnosis.
Differential diagnosis
According to generalized flat sputum rash and histopathological changes, it can be diagnosed, but should be differentiated from the following diseases:
(1) sacral keratosis rash occurs in the back of the hands and feet, knee and elbow, etc., is a flattened papule, histopathology: no cells in the upper epidermis form vacuoles.
(2) Lichen planus is a purple-red papule, itchy, often mucosal damage, pathology: epidermal hyperkeratosis, irregular acanthosis, basal cell liquefaction degeneration, dermal banded cell infiltration.
