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NEJM：震撼！全身皮肤变黑案例报道

2016-03-24 chenshuo译 MedSci原创

黑色素瘤皮肤色素沉着
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男性，76岁，因全身乏力而入院就诊。

男性，76岁，因逐渐全身乏力而入院就诊。



据该患者主诉，在几个星期之前便开始发现自己的头面部出现广泛的蓝灰色肤色改变，到至今为止这种现象愈发严重。

在14个月前，该患者曾做过BRAF基因突变检测，当时检测的结果为阴性，否认了患有恶性黑色素瘤的可能性。但在5个月前发现有肝、脾多发性转移现象。对此，该患者接受了为期4周的氮烯唑胺药物治疗。

目前，由于其身体皮肤肤色的变化严重，如今已经不能通过其身份证辨别其本人。

本案例中，根据以上所述的临床症状及检查结果，会诊医师确诊其患上了弥漫性皮肤黑变病，皮肤肤色的改变正是该病导致的结果。

一般来说，患有皮肤黑变病的患者存活期不长，大概是6个月左右。然而，这个病人在皮肤黑变病发病加重后存活了16个月，这是以往是非常罕见的。

原始出处：

Theresa Jansen, M.D., and Norman-Philipp Hoff, M.D. Diffuse Melanosis Cutis
N Engl J Med 2016; 374:1177March 24, 2016

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    2016-04-21 1de8e1afm39(暂无匿称)

    全文为什么没有

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=80085, encodeId=2f5f800851b, content=全文为什么没有, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160327/IMG56F7D60F101C42150.jpg, createdBy=3ab61705271, createdName=1de8e1afm39(暂无匿称), createdTime=Thu Apr 21 21:56:00 CST 2016, time=2016-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=73945, encodeId=39d4e394594, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a6a1604604, createdName=Gsurgeon, createdTime=Sun Mar 27 06:20:00 CST 2016, time=2016-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=73792, encodeId=5059e379289, content=看看生物化学，芳香族氨基酸代谢就对路子了嘛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=225a1697989, createdName=1de7460am01(暂无匿称), createdTime=Fri Mar 25 22:03:00 CST 2016, time=2016-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=73701, encodeId=5102e37014e, content=还有这事, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Fri Mar 25 07:11:00 CST 2016, time=2016-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=73702, encodeId=e8fbe370265, content=疑难杂症, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Fri Mar 25 07:11:00 CST 2016, time=2016-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=73670, encodeId=d2fee367007, content=属于罕见病例报道！, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Fri Mar 25 01:14:00 CST 2016, time=2016-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=73656, encodeId=f51fe3656a0, content=学习了，找原文看看去。谢谢！, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73891704316, createdName=1de8af32m63(暂无匿称), createdTime=Thu Mar 24 22:17:00 CST 2016, time=2016-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=73630, encodeId=2420e363052, content=希望疑难杂症都能治愈, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6b0d1671629, createdName=1de11f7fm56(暂无匿称), createdTime=Thu Mar 24 18:40:00 CST 2016, time=2016-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=73615, encodeId=00aae361573, content=长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Mar 24 18:03:00 CST 2016, time=2016-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=73610, encodeId=861ce36103c, content=学习了，谢谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73801651090, createdName=1ddc978cm67(暂无匿称), createdTime=Thu Mar 24 18:01:00 CST 2016, time=2016-03-24, status=1, ipAttribution=)]
    2016-03-27 Gsurgeon

    学习了谢谢

    0

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    2016-03-25 1de7460am01(暂无匿称)

    看看生物化学，芳香族氨基酸代谢就对路子了嘛。

    0

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    2016-03-25 milkshark

    还有这事

    0

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    2016-03-25 milkshark

    疑难杂症

    0

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    2016-03-25 Lisa971

    属于罕见病例报道！

    0

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    2016-03-24 1de8af32m63(暂无匿称)

    学习了，找原文看看去。谢谢！

    0

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    2016-03-24 1de11f7fm56(暂无匿称)

    希望疑难杂症都能治愈

    0

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    2016-03-24 李继凯

    长见识了

    0

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    2016-03-24 1ddc978cm67(暂无匿称)

    学习了，谢谢。

    0

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