Eczema-like carcinoma
Introduction
Introduction to eczema-like cancer Eczema-like cancer (eczematoidcarcinoma), also known as Pagetdisease, is clinically characterized by eczema-like lesions, a special type of cancer characterized by large, lightly stained abnormal cells (Paget cells) in the epidermis. According to the different parts of the disease, it can be divided into two types: Pagetdiseasebreast and extramary Pagetdisease. The former occurs in the nipple and areola, and the latter is commonly found in the apocrine sweat gland distribution area, such as female genitals, male genitalia, anus. , parotid gland and ciliary gland. Traditional Chinese medicine chyle is similar to this disease. It is believed to be caused by seven emotions, liver stagnation and stomach heat, spleen loss of health, dampness and heat, and clotting to block the skin. basic knowledge The proportion of the disease: the incidence of this disease is low, generally 0.01% - 0.02% Susceptible people: no special people Mode of infection: non-infectious Complications: skin cancer
Cause
Eczema-like cancer etiology
(1) Causes of the disease
The cause is currently unknown.
(two) pathogenesis
At present, it is believed that the disease originates from the carcinoma of the duct of the milk duct and the apocrine sweat gland, and extends from the breast duct and the glandular epithelium downwards, and finally can invade the connective tissue to form breast cancer, and then expands into the epidermis. Paget disease, extra-thoracic Paget disease is often associated with glandular adjunct cancer or local metastatic or non-metastatic cancer. Paget cells originating from the milk duct or apocrine sweat gland can be supported by:
1. Paget cells contain carcinoembryonic antigen (CEA).
2. Paget cells often contain neutral mucopolysaccharides like apocrine sweat glands and breast cells.
3. Immunohistochemistry confirmed that Paget cells in the epidermis of breast Paget's disease showed positive and malignant apocrine adenoma positive markers GCDFP-15 (gross cystic disease fluid protein-15) and CK7 (keratin type7) positive, Chinese medicine believes that seven emotions Injury, liver stagnation and stomach heat, spleen loss of health, dampness and heat, clotting and blocking the skin.
Prevention
Eczema-like cancer prevention
Strengthen physical exercise, enhance physical fitness, and exercise more in the sun. Excessive sweating can excrete acidic substances in the body with sweat, avoiding the formation of acidic body. Have a good attitude to cope with stress, work and rest, do not fatigue. Visible pressure is an important cause of cancer. Chinese medicine believes that stress leads to excessive physical weakness, which leads to decreased immune function, endocrine disorders, metabolic disorders in the body, leading to the deposition of acidic substances in the body. Stress can also lead to mental stress causing qi stagnation and blood stasis. Invagination and so on.
Don't eat too much salty and spicy food, don't eat food that is overheated, too cold, expired and deteriorated; those who are frail or have certain genetic genes should eat some cancer-preventing foods and alkaline substances with high alkalinity as appropriate. Food, maintain a good mental state to develop good habits, stop smoking and limit alcohol. Smoking, the World Health Organization predicts that if people no longer smoke, after five years, the world's cancer will be reduced by 1/3; secondly, no alcohol. Smoke and alcohol are extremely acidic and acidic substances. People who smoke and drink for a long time can easily lead to acidic body.
Complication
Eczema-like cancer complications Complications skin cancer
Associated with intradermal invasive cancer. Early invasive squamous cell carcinoma can be characterized by smaller papular nodules or patches, which gradually become larger, bulge, and become plaques, which can eventually form huge sickle lesions. Invasive squamous cell carcinoma often develops ulcers, and ulcers are likely to cause secondary infections. Therefore, many invasive squamous cell carcinomas have pus exudation and thick crust, accompanied by odor.
Symptom
Eczema-like cancer symptoms Common symptoms Generalized red plaque scars
Breast Paget's disease is almost completely seen in the breasts of middle-aged and elderly women. A few are also found in male breasts. Skin lesions occur in the unilateral breast and areola, showing painless red plaques, often accompanied by eczema, superficial erosion, and infiltration. Liquid or crusting, can form ulcers and nipple retraction, touch a firm feeling, the skin lesions slowly expand to the surrounding, can also remain still, often accompanied by breast cancer, more than half of the breast can touch the mass, about 2/3 In patients with lumps, there may be axillary lymph node metastasis. Extramammary Paget's disease can be seen in both sexes, but it is still more common in women. The average age of onset is later than that of breast Paget disease. Most of them are found in female genitals, followed by scrotum, perineum, and anus. Weekly, it can also be seen in the apocrine sweat gland outside the genital area, such as the armpit, and even the parotid gland and ciliary gland. The skin lesions are similar to the Paget disease of the breast. They also have clear red patches with eczema-like scars and erosions. It is often slightly higher than the skin surface, which is larger than the skin lesion of the Paget disease, and often has itching sensation. The paget disease outside the breast is generally better than the breast Paget disease, and it is only about 20% with the intradermal invasive cancer. Even see the breast outside Paget The disease can also be extended from the rectal adenocarcinoma that secretes mucus to the perianal skin or from the cervical cancer that secretes mucus to the genital area, which is called secondary extra-abdominal Paget disease, and the prognosis is poor.
Examine
Eczema-like cancer examination
Histopathology: It is characterized by single or nested paget cells in the epidermis. The cells are large, round or elliptical, without intercellular bridges. The cells contain a large nucleus, which is rich in cytoplasm and lightly stained or even empty. Foamy, when Paget cells increase, the surrounding epidermal cells can be extruded into a network, especially the epidermal basal cells are often extruded into a thin band, Paget cells are positive for PAS, amylase resistant, moderately chronic in the dermis Inflammatory cell infiltration, immunohistochemical examination of CEA, GCD-FP-15 and CK7 positive, histopathology can also be seen from the epidermis extending from the irregular expansion of the tubular structure can be identified.
Bowen disease can occur in any skin and mucous membranes, rarely invading the nipple and areola, clinically should be differentiated from extramammary Paget's disease, but Bowen's disease pathology shows keratinocytes and multinuclear giant epidermal cells different from Paget's disease .
Diagnosis
Diagnosis and diagnosis of eczema-like cancer
According to clinical manifestations and lesion characteristics, histopathology can be diagnosed.
1. Breast eczema: usually occurs symmetrically on both sides of the breast, the edge is not clear, when the time is good, itching is obvious, more common in lactating young women, according to eczema treatment is more effective.
2. erosive adenomatosis of the nipple: early nipple erosive inflammation, often serous exudation, clinically very similar to breast paget disease, advanced nipples with nodular enlargement easily identified.
