遠心性環狀紅斑：一位合併乳癌的病例報告

Erythema Annulare Centrifugum Associated with Breast Carcinoma: Report of a Case

魏秀娟(Shiow-Jiuan Wey) ； 陳得源(Der-Yuan Chen) ； 施宏俊(Hung-Chun Shih) ； 楊仁宏(Jen-Hung Yang)

《中山醫學雜誌》 15卷2期 (2004/12) Pp. 235-240

https://doi.org/10.30096/CSMJ.200412.0012

摘要

遠心性環狀紅斑目前真正的原因不明，部份與感染性疾病、自體免疫疾病或腫瘤疾病有關。我們的患者為55歲女性，罹患脊椎關節病變並規則服用藥物已有七年。民國92年11月開始在其頸部、軀幹與四肢出現許多環狀的紅色斑塊，使用抗黴菌藥膏外用治療及照光治療，效果不佳。患者接受皮膚切片檢查，病理變化可見局部表皮細胞海綿化、淺層的真皮組織水腫及明顯的血管周圍發炎細胞浸潤，與淺層型遠心性環狀紅斑之病理發現相一致。半年後，患者在其左側乳房摸到硬塊，並於93年7月接受左側乳房全切除，病理檢查證實為乳腺管癌，並接受三個月的化學藥物治療，其遠心性環狀紅斑自行消褪，至93年12月其乳癌及皮膚病變皆未再復發。此患者是首位合併乳癌之遠心性環狀紅斑病例。

關鍵字

遠心性環狀紅斑 ； 乳癌

並列摘要

Erythema annulare centrifugum (EAC) is often associated with infectious, autoimmune or neoplastic diseases, nevertheless, the etiology and pathogenesis of this disease remain unclear. We reported a 55-year-old woman who had a history of spondyloarthropathy and been treated regularly in a medical center for seven years. The patient presented with reddish skin rashes over the neck and lower limbs since November 2003 and the skin lesions did not respond to topical antifungal treatment. The patient then visited our clinic for her skin lesions, presenting multiple annular or arciform erythematous patches with scales centrifugally involving neck, trunk and four limbs. Skin scraping for KOH preparation was negative for fungus. We took skin biopsy from the back lesion for pathological examination to show mild epidermis spongiosis and dermal perivascular mononuclear cells infiltration, consistent with the pathological findings of EAC. The patient was then treated with topical steroids and narrow-band phototherapy, but the lesions still waxed and waned. Six months later, the patient discovered a non-tender mass in her left breast by self-palpating, and the mass was later proven to be mammary ductal carcinoma. She underwent a total mastoidectomy in July 2004, and then received chemotherapy for a consecutive three months. The skin lesions of EAC resolved spontaneously and completely after the operation without any sign of relapse of EAC skin lesions, nor the recurrence of breast carcinoma in the two months after the chemotherapy. To our knowledge, this is the first documented case with a concurrence of EAC and breast carcinoma.

並列關鍵字

Erythema annulare centrifugum ； Breast cancer