skin leiomyoma
Introduction
Introduction to cutaneous leiomyoma Leiomyomacutis is a benign tumor composed of skin fascia, mesothelial or vascular smooth muscle. There are few skin smooth muscles, mainly found in the hairy muscles near the hair follicles, the muscle fibers around the deep subcutaneous blood vessels, the smooth muscle bundles in the scrotum and the labia. Therefore, the leiomyomas tend to have a neck surface, limbs and perineum. Including simple leiomyoma and vascular smooth muscle tumors associated with vascular structure. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: soft tissue tumors, lipoma, epidermoid cyst
Cause
Cause of cutaneous leiomyomas
(1) Causes of the disease
Abnormal hyperplasia of smooth muscle of the skin.
(two) pathogenesis
Leiomyoma is composed of smooth muscle cells. These cells are mostly fusiform or slightly corrugated. They are often arranged in parallel. The nucleus is central, blunt, cytoplasm rich, contains longitudinal fibrils, and smooth muscle located in the subcutaneous tissue. Tumors often have a capsule, located in the dermis, although the boundaries are clear, but generally no capsule, vascular leiomyoma, often complete capsule, the tumor contains many large blood vessels, these blood vessels do not contain elastic membrane.
Prevention
Skin leiomyomatosis prevention
There are no effective preventive measures for this disease. Pay attention to health, do a good job of safety protection, reduce and avoid the irritating and accidental injury of adverse factors, can play a certain preventive role; In addition, early detection, early diagnosis and early treatment are also the key to prevention and treatment of this disease. In case of onset, active treatment should be actively treated to prevent complications.
Complication
Skin leiomyomas complications Complications soft tissue tumor lipoma epidermoid cyst
Multiple leiomyomas can be combined with other soft tissue tumors, such as lipomas, fibroids, epidermoid cysts, etc., and can also coexist with exostoses and intestinal polyps, becoming part of the Gardner syndrome.
Symptom
Symptoms of leiomyomas of the skin Common symptoms Muscle fiber size varies from papules to fatigue Skin adhesion blood from the veins cold stimulates the skin lesions...
There are three types depending on the source of tumor cells.
1. Hair leiomyomas (piloleiomyomas) Men are more common, can be more or a single hair, occur in the face and neck, back and extremities, the side is hard solid nodules, higher than the leather surface, the size is different, the diameter is From a few millimeters to a few centimeters, the mass adheres to the skin, but the base can be pushed, the surface of the skin is reddish brown, brown or blue, and the multiple skin lesions are asymmetrical, often clustered and can be fused into pieces. Can be scattered, the diameter of the lesion is 0.1 ~ 0.6cm, single hair, large nodules, diameter up to 2cm, tender, spontaneous pain in cold and compression, tumor bulge in pain, clusters Nodules can sometimes fuse into plaques, most of which are sensitive to touch, with spontaneous pain and no symptoms.
2. dartoic leiomyoma (dartoic leiomyoma) also known as genital leiomyomas from nipple or genital smooth muscle, occurs in the nipple or scrotum, labia majora, lesions with a single nodule, clear boundaries, diameter About 0.5 ~ 1cm, the surface can be normal skin color, or red or light blue, can grow up to several centimeters, early no symptoms, paroxysmal pain.
3. Angiomyomyoma is more common, often occurs in adult women (average 47 years old), derived from vascular smooth muscle, the lesion is usually a single nodule, spherical, can be pushed, diameter 0.5 ~ 10cm The skin color is blue-violet, often with paroxysmal tingling or tenderness. It lasts for 2 to 3 minutes and can be induced by cold, exercise, oppression, emotional agitation or fatigue. The degree of pain gradually increases with time, and the course is slow. Regression, common in female lower limbs, especially the flexion of the lower leg and the foot, usually located in the subcutaneous tissue, may also involve the dermis.
Examine
Examination of cutaneous leiomyoma
Histopathological examination: smooth muscle cells were seen in the tumor, which were long fusiform or slightly corrugated, often arranged in parallel.
1. vascular leiomyoma: originated from the muscle of the vein wall, located under the skin, with a complete capsule, a number of veins in the tumor tissue, smooth muscle cells and collagen hyperplasia, narrow or compressed into a star shape, no internal elastic membrane and Outer membrane, more common hyaline changes and mucus-like changes, smooth muscle cells and surrounding tumor tissue no obvious boundary, mature adipose tissue, atypical changes, mitosis and necrosis are rare.
2. Genital leiomyomas and hair leiomyomas: composed of a large number of disordered smooth muscle cells and collagen, hair and appendages are susceptible, eosinophilic staining of tumor cells, vacuolization around the nucleus, nuclear centering, long fusiform, Both ends are obtuse, the chromosomes are evenly distributed, the genital leiomyoma, the boundary is relatively clear, and it is located in the subcutaneous tissue. Both of them can form a pseudo-envelope, and local calcification and mucus-like changes appear. If mitosis occurs, the malignant transformation should be guarded.
Diagnosis
Diagnosis and diagnosis of cutaneous leiomyoma
diagnosis
Single or clustered painful papules or nodules appear clinically, and should be considered when the surface of the lesion is shrunk under cold stimulation.
Differential diagnosis
1. Small sweat gland sac: small and soft, evenly distributed, no pain, and genital leiomyoma shrinks when cold or touched; single vascular leiomyoma has pain, multiple or single skin leiomyomas The pain is obvious.
2. Skin fibroids: mainly for the proliferation of collagen fibers, microscopically seen cells slender, light iridescent red stain; nucleus ellipse, both ends are sharp, Van Gieson staining collagen fibers are red, Masson staining collagen fibers are green.
3. Schwannoma: occurs in the nerve trunk, mostly located in the flexor side of the limbs, can be pushed left and right, but can not move up and down, pathological examination shows that the tumor cells are more slender, wavy, the cytoplasm is light red, the nucleus is slender, Arranged in a fence.
4. Highly differentiated leiomyosarcoma: Tumor cells are mildly atypical, with one or several mitotic figures found every 30 high power fields.
