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Winter 2019, Vol. 27 No. 4

Hong Kong J. Dermatol. Venereol. (2019) 27, 185-191


Case Report

Collision tumour of actinic keratosis and basal cell carcinoma with different dermoscopic features

光化性角化病與基底細胞癌的碰撞性瘤之不同皮膚鏡特徵

TK Uzuncakmak, BN Akay, AS Karadag, MC Koska, AO Heper, BC Simsek

Abstract

Background: Collision tumours are rare neoplastic lesions consisting of different benign and malignant tumours in the same anatomical site. Various intrinsic and extrinsic factors such as ageing, skin type, UV exposure may lead development of different tumoural lesions. Objective: The aim of the present study was to identify and clarify dermoscopic features of collision tumour of actinic keratosis and basal cell carcinoma which can be a diagnostic pitfall both clinically and dermoscopically. Methods: Dermoscopic features of five histopathologically-proven collision tumours of actinic keratosis and basal cell carcinoma and their dermatopathological correlates were retrospectively analysed. Results: On dermoscopy, coiled vessels surrounded by a whitish halo were detected in one lesion. Small blue-gray blotches were detected in all lesions even located on periphery or centrally. White circles, prominent follicular openings, four dot structures (rosettes) were detected in one lesion. Pink structureless areas were detected in three of the lesions. Conclusion: Clinicians should consider collision tumour when a lesion contains dermoscopic features of more than one type of tumour.

背景:碰撞性瘤是罕見的腫瘤性病變,由相同解剖部位的不同良性和惡性腫瘤構成。各種內在和外在的因素(例如衰老、膚色類型、紫外線暴露)都可能導致不同腫瘤病變的發展。目的:本研究的目的是鑑定和闡明光化性角化病和基底細胞癌的碰撞性瘤的皮膚鏡特徵,這正正因為它是臨床和皮膚鏡檢查診斷中的常見陷阱。方法:回顧性分析五例經組織病理學證實的光化性角化病和基底細胞癌碰撞性瘤的皮膚鏡特徵及其皮膚病理學相關性。結果:在皮膚鏡檢查中,所有五例病變中,無論是外圍或中心都檢測到細小藍灰色斑點;三例病變中發現了粉紅色的無結構區域。此外,一例見到有盤繞的血管被白色光暈包圍,另一例病變則見到白色圓圈、明顯的毛囊開口和四個點結構(玫瑰花結)。結論:當病變的皮膚鏡特徵不限於一種腫瘤類型時,醫生應考慮碰撞性瘤的可能。

Keywords: Actinic keratosis, basal cell carcinoma, collision tumour, dermoscopy

關鍵詞: 光化性角化病、基底細胞癌、碰撞性瘤、皮膚鏡