中国的砷角化病:病例报告和文献综述。

IF 2 4区 医学 Q3 DERMATOLOGY Skin Research and Technology Pub Date : 2024-09-01 DOI:10.1111/srt.13903
Rong Tao, Ruojun Wang
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引用次数: 0

摘要

背景:砷角化病是一种癌前皮肤病,可能由长期接触砷中毒诱发。为了提高银屑病的治疗效果,中药中经常不规范地添加砷,这往往是导致中国银屑病患者砷中毒的主要原因:我们对过去 32 年砷角化病进行了系统回顾,以更好地了解中国砷角化病的来源、治疗和预后:我们检索了 Medline/PubMed、Embase、CNKI 和万方数据库中 1992 年至 2024 年间发表的研究报告。本分析共纳入 64 篇论文,78 名中国砒霜角化病患者:在纳入分析的患者中,92.21%的砷中毒患者是由先天性因素引起的:中药76例患者(98.70%)的皮肤表现为角化过度的丘疹和斑块,68例患者(88.31%)有色素沉着,43例患者(55.84%)有色素减退,只有4例患者的指甲有明显的梅氏纹。52.63%的患者患有肿瘤,包括鳞状细胞癌、鲍温氏病和基底细胞癌。在患有肿瘤的患者中,20 人选择了手术治疗,6 人选择了放射治疗,3 人选择了光动力疗法。目前,所有仅患有皮肤肿瘤的患者都得到了很好的控制。一名转移性鳞状细胞癌患者死亡。70.59%的患者在接受阿维A酸胶囊治疗后,角化性丘疹明显好转:在这项研究中,中国患者的砷来源主要来自传统中药,在过去 32 年中没有关于接触水源或职业来源的报告。大多数患者表现为角化性丘疹和色素沉着,1/2 以上的患者表现为皮肤肿瘤,主要是鳞状细胞癌。对肿瘤的治疗以手术治疗为主,也可选择光动力疗法和放射治疗。阿昔替丁胶囊对角化性皮疹的改善率超过 70%。对该病患者应定期随访,以便早期发现并及时治疗潜在的恶性肿瘤。
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Arsenical keratosis in China: A case report and review of the literature.

Background: Arsenical keratosis is a precancerous dermatosis which could be induced by long-term exposure to arsenic poisoning. Arsenic is often added to traditional Chinese medicine in a non-compliant manner to increase the effectiveness of psoriasis treatment, which is often the main cause of arsenic poisoning in Chinese patients with psoriasis.

Objectives: We performed a systemic review of arsenic keratosis during the past 32 years to better understand the sources, treatment, and prognosis of arsenic keratosis in China.

Methods: We searched Medline/PubMed, Embase, CNKI, and Wanfang databases for research studies published between 1992 and 2024. A total of 64 papers with 78 individual Chinese of arsenical keratosis were included in this analysis.

Results: Of the patients included in the analysis, 92.21% of arsenic poisoning was due to iatrogenic factors: Chinese traditional medicine. Seventy-six patients (98.70%) had skin manifestation of hyperkeratotic papules and plaques, 68 patients (88.31%) had hyperpigmentation, 43 cases (55.84%) had hypopigmentation, and only 4 had a clear indication of Mees' lines in nails. A total of 52.63% of patients presented with tumors, including squamous cell carcinoma, Bowen's disease, and basal cell carcinoma. For patients with tumors, 20 opted for surgery, 6 for radiotherapy, and 3 for PDT. All patients with only cutaneous tumors are currently well-controlled. Death occurred in one patient with metastatic squamous cell carcinoma. Keratinizing papules improved significantly in 70.59% of patients treated with Acitretin Capsules.

Conclusions: In this study, arsenic sources in Chinese patients were mainly from traditional Chinese medicine, and there were no reports of exposure to water sources or occupational sources in the past 32 years. Most of the patients showed keratinizing papules and pigmentation, and more than 1/2 of the patients showed skin tumors, mainly squamous cell carcinoma. The treatments of tumors are mainly surgical treatment, PDT and radiotherapy can also be selected. The improvement in keratinizing rash was greater than 70% with acitretin capsules. Patients with this disease should be regularly followed up for early detection and timely treatment of potential malignant tumors.

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来源期刊
Skin Research and Technology
Skin Research and Technology 医学-皮肤病学
CiteScore
3.30
自引率
9.10%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Skin Research and Technology is a clinically-oriented journal on biophysical methods and imaging techniques and how they are used in dermatology, cosmetology and plastic surgery for noninvasive quantification of skin structure and functions. Papers are invited on the development and validation of methods and their application in the characterization of diseased, abnormal and normal skin. Topics include blood flow, colorimetry, thermography, evaporimetry, epidermal humidity, desquamation, profilometry, skin mechanics, epiluminiscence microscopy, high-frequency ultrasonography, confocal microscopy, digital imaging, image analysis and computerized evaluation and magnetic resonance. Noninvasive biochemical methods (such as lipids, keratin and tissue water) and the instrumental evaluation of cytological and histological samples are also covered. The journal has a wide scope and aims to link scientists, clinical researchers and technicians through original articles, communications, editorials and commentaries, letters, reviews, announcements and news. Contributions should be clear, experimentally sound and novel.
期刊最新文献
Using Wavelet Analysis of Blood Flow Oscillations to Investigate Differences in Skin Blood Flow Regulations Between the Upper and Lower Limbs. Cold Plasma Ameliorates Imiquimod-Induced Psoriasis-Like Skin Inflammation in Mice. Commentary on "Analysis of Factors Influencing the Recurrence of Diabetic Foot Ulcers". Development and Validation of a Total Body Photo-Numeric Freckling Density Scale. Involvement of Sex Hormones and Their Receptors in the Pathogenesis of Classic Kaposi's Sarcoma in Xinjiang.
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