新英格兰IMAGES IN CLINICAL MEDICINE:瘢痕疙瘩

一位24岁男性因肺包虫病而行手术治疗,术后8周在切口部位皮肤出现瘤样无症状病变。患者同时还行阿苯达唑作为辅助疗法。诊断为瘢痕疙瘩瘢痕疙瘩一般因手术,外伤,烧伤或者皮肤炎症等损伤真皮而引起。瘢痕疙瘩易复发,所以不推荐手术治疗,一般可以采用糖皮质激素局部封闭治疗,激光治疗或者放射治疗方法,但疗效常欠佳。本例患者因皮损较大,采用手术切除治疗,同时进行糖皮质激素局部封闭。术后1月未见复发,现已失访。

新英格兰IMAGES IN CLINICAL MEDICINE:瘢痕疙瘩

Incisional Keloid

A 24-year-old man underwent thoracic surgery for pulmonary hydatid disease, and 8 weeks later, asymptomatic, tumorlike, cutaneous lesions developed over the incision site. The patient was receiving albendazole as an adjunct therapy. A clinical diagnosis of keloid was made. Keloids typically occur in response to dermal injuries such as surgical wounds, lacerations, burns, or inflammatory skin conditions. Because recurrence is common, surgical removal is generally not recommended; treatments with glucocorticoid injections, laser therapy, or radiotherapy may be tried but are usually associated with a poor response. Given the large size of the lesion in this patient, surgical excision was performed, with an immediate infiltration of glucocorticoids. There was no recurrence 1 month after surgery, and the patient was lost to further follow-up.

后记

看到新英格兰发表的这个病例,心理默默的蛋疼。瘢痕疙瘩我们临床上太常见了,比这大的,比这严重的多的是。可是我们在临床工作中却忽略了一个重要的事实,这种病例也能发,而且是国际最NB的杂志。

从这个病例可以看出,在临床工作中,我们一定时刻保持警惕的心,很多病例在我们眼里感觉可能都很普通,可是在歪国人眼里可能就很稀奇。

原文链接:http://www.nejm.org/doi/full/10.1056/NEJMicm1407180

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