背景:砷角化病是一种长期暴露于砷中毒的癌前皮肤病。中药中常以不依从的方式加入砷,以增加银屑病治疗的效果,这往往是中国银屑病患者砷中毒的主要原因。
目的:我们在过去32年中对砷角化病进行了系统回顾,以更好地了解其来源,治疗,中国砷角化病及预后分析.
方法:我们搜索了Medline/PubMed,Embase,CNKI,和1992年至2024年间发表的研究研究的万方数据库。该分析共包括64篇论文,其中78位中国人患有砷性角化病。
结果:在分析中包括的患者中,92.21%的砷中毒是由于医源性因素:中药。76例(98.70%)患者有过度角化性丘疹和斑块的皮肤表现,68例患者(88.31%)有色素沉着过度,43例(55.84%)有色素沉着减退,只有四个人在指甲上清楚地显示了Mees\'线条。共有52.63%的患者出现肿瘤,包括鳞状细胞癌,Bowen病,和基底细胞癌.对于肿瘤患者,20人选择了手术,6用于放射治疗,3用于PDT。目前,所有仅患有皮肤肿瘤的患者都得到了良好的控制。1例转移性鳞状细胞癌患者死亡。在接受阿维A胶囊治疗的70.59%的患者中,角化性丘疹得到了显着改善。
结论:在这项研究中,中国患者的砷源主要来自中药,在过去32年中,没有接触水源或职业来源的报告。大多数患者表现为角质化丘疹和色素沉着,超过1/2的患者出现皮肤肿瘤,主要是鳞状细胞癌。肿瘤的治疗主要是手术治疗,也可以选择PDT和放射疗法。阿曲汀胶囊对角化性皮疹的改善大于70%。本病患者应定期随访,及早发现并及时治疗潜在的恶性肿瘤。
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.
OBJECTIVE: 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.