小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 单发或多发鳞屑性斑疹或斑块
- 表面角化过度的鳞屑性皮损
- 边界清楚的鳞屑性褐色皮损
- 类似于脂溢性角化病、色素痣及早期恶性黑素瘤的皮损
- 高出皮肤表面的肥厚性锥形突起
- 下唇至唇角接合处可见红斑鳞屑性粗糙面，其上可发生硬化、皲裂和溃疡
- 皮损位于日光暴露部位
- 肤色、乳头瘤样、突起于皮面的疣状丘疹
- 非常轻微的鳞屑样斑块，其下皮肤薄而发亮
- 紫红色、边界清楚的丘疹，表面可见细小白色条纹
其他诊断因素
- 皮肤日光损伤的证据
- 瘙痒或出血
危险因素
- 慢性UVB暴露
- 浅肤色、长有雀斑或是白化病
- 年龄＞40 岁
- 男性
- 免疫功能受损
- 着色性干皮病
诊断性检查
需考虑的检查
- 皮肤镜检查
- 皮肤活检
治疗流程
融合性头皮皮损
头面部皮损不包括眶周皮损、光化性唇炎以及头皮融合性皮损
眶周
持续或重度光化性唇炎
手背
膝关节以下
撰稿人
作者
Brian Berman, MD, PhD
Professor Emeritus of Dermatology and Cutaneous Surgery
University of Miami Miller School of Medicine
Miami
Skin & Cancer Associates, LLP
Co-Director
Center for Clinical and Cosmetic Research
Aventura
FL
利益声明
BB is, or has been, a paid consultant/advisor for Almirall (manufacturer of tirbanibulin), TopMD, Lemonex, Berg Pharma, Novartis, Aiviva, Ferndale, Sensus, Novan, Klara, Pierre Fabre (manufacturer of 5-FU), Biofrontera (manufacturer of ALA), SUN (manufacturer of ALA), LEO (manufacturer of ingenol mebutate), Pulse, Sirnaomics, Menlo, Sonoma, PHD Biosciences, Birch BioMed, Mediwound, Mino Labs. He has been a speaker for Almirall (manufacturer of tirbanibulin), LEO (manufacturer of ingenol mebutate), Sensus. His institution has received investigator funding from Biofrontera (manufacturer of ALA), LEO (manufacturer of ingenol mebutate), Pulse, Sirnaomics, Menlo, Birch BioMed, Mediwound.
Sadegh Amini, MD
Dermatologist
Skin and Cancer Associates
Voluntary Assistant Professor
Department of Dermatology and Cutaneous Surgery
University of Miami
Miller School of Medicine
Miami
FL
利益声明
SA declares that he owns stock in AbbVie Inc.
同行评议者
David S. Cassarino, MD, PhD
Assistant Professor
Departments of Pathology and Dermatology
UCLA
Los Angeles
CA
利益声明
DSC declares that he has no competing interests.
Christopher Shea, MD
Dermatopathology Fellowship Director
University of Chicago
Section of Dermatology
Chicago
IL
利益声明
CS declares that he has no competing interests.
鉴别诊断
- 原位鳞状细胞癌（鲍恩病）
- 侵袭性鳞状细胞癌
- 角化棘皮瘤
更多 鉴别诊断指南
- 重点更新：光化性角化病治疗指南
- 关于光化性角化病管理的诊疗指南
更多 指南
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明