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患者男,58岁。因躯干部皮肤起黑褐色斑丘疹20年余,近2个月突然增多来我科就诊。患者诉20年前下腹部长褐色斑丘疹,无明显自觉症状,遂未予治疗。近5年来皮损渐累及胸、背部及双上肢共约三四百个,近2个月突然增加一百多个,原有皮疹亦较前面积增大。发病以来,无发热乏力,精神尚可,饮食正常,大小便正常。初步诊断为Leser-Trelat征。为排除患者潜在内脏肿瘤,查肿瘤抗原全套:前列腺特异性抗原(PSA)13.37μg/L(正常值≤4μg/L,以下同),游离前列腺特异性抗原(fPSA)/PSA比值为0.14(0.16~1.00),余无明显异常。建议转泌尿外科
Male patient, 58 years old. Due to trunk skin dark brown rash more than 20 years, nearly 2 months suddenly increased to our department. Patient v. 20 years ago, the lower abdomen long brown rash, no obvious symptoms, then no treatment. Skin lesions over the past 5 years and chest gradually, the back and upper extremities of a total of about three or four hundred, nearly two months suddenly increased more than 100, the original rash also increased compared with the previous area. Since onset, no fever, lack of energy, the spirit is acceptable, normal diet, normal urine. Initial diagnosis of Leser-Trelat sign. In order to rule out potential visceral tumors in patients with prostate cancer, a full set of tumor antigen: prostate specific antigen (PSA) of 13.37μg / L (normal ≤ 4μg / L, the same below), free prostate specific antigen (fPSA) / PSA ratio of 0.14 ~ 1.00), I no obvious abnormalities. Recommended to urology