摘要
患者，女，19岁。乳房间、胸背部密集棕褐色斑丘疹，微痒4年。患者无明显诱因，乳房间、前胸出现米粒大褐红色丘疹，偶痒，后皮疹逐渐增多，增大并累及双乳内侧和漫延至肩背、腰部，形成密集网状样外观。背部皮屑直接镜检：可见少量圆形孢子。组织病理示：表皮轻度角化，颗粒层变薄，棘层肥厚，真皮轻度水肿，血管周围有非特异性炎性细胞浸润。诊断为融合性网状乳头瘤病。经伊曲康唑、米诺环素口服，结合中药外洗及维甲酸乳膏外涂等综合治疗，取得满意疗效。肩背、腰部网状色沉经2次光子治疗后大部分消退，随访1年未见复发，其治疗方法值得同行借鉴。
关键词： 皮肤乳头瘤病；褐色丘疹；融合成网状
Abstract
The patient, female, 19 years old. Dense brownish brown spotted papules Between the breast, chest and back, slightly itching for 4 years. The patient has no obvious inducement. There are large brown red papules with rice grains in Between the breast and front chest, which are occasionally itchy. The rear rash gradually increases, increases and involves the inner side of both breasts and spreads to the shoulder, back and waist, forming a dense reticular appearance. Direct microscopic examination of back dander: a small amount of round spores can be seen. Histopathology showed mild keratinization of epidermis, thinning of granular layer, hypertrophy of spinous layer, mild edema of dermis, and nonspecific inflammatory cell infiltration around blood vessels. Diagnosis:Confluent and reticulated papillomatosis. After oral administration of itraconazole and minocycline, combined with external washing of traditional Chinese medicine and external application of retinoic acid cream, satisfactory results were obtained. The reticular pigmentation of shoulder, back and waist subsided after 2 times of photon treatment, and there was no recurrence after 1 year of follow-up. Its treatment method is worthy of reference.
Key words： Cutaneous Papillomatosis; Brown Papules; Fused Into A Network
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