Clinical And Pathological Analysis And Research Of 674 Cases Of Cutaneous Appendage Tumor

Objectives:1.To investigate and understand the epidemiological trend of cutaneous appendage tumor(CAT)in yunnan province2.To analyze and study the clinical and histopathological features of different types of cutaneous appendage tumor,and to have an in-depth understanding of cutaneous appendage tumor,so as to improve the coincidence rate of early diagnosis,achieve early diagnosis and treatment,improve the prognosis of patients and improve their quality of life.Methods:From January 2008 to December 2018,the dermatology department of the first affiliated hospital of Kunming Medical University reviewed and analyzed 674 cases of cutaneous appendage tumors that were clinically and histopathologically diagnosed.The clinical and pathological data of the subjects were classified,and the clinical and pathological analyses of different types of cutaneous appendage tumors were summarized.Results:1.The general clinical data:A total of 674 cases of cutaneous appendage tumors were selected,291 were male(43.18%),383 were female(56.82%),and the male-to-female ratio was 1:1.32.The age of onset ranged from 0 to 82 years,with an average age of 23.13±19.711 years and a median age of 19 years.There was no statistical difference in the age of onset between male and female patients.The age of onset ranged from 0 to 82 years in males,with an average age of 22.76±20.042 years,and the median age was 19 years.The age of onset ranged from 0 to 78 years in females,with an average age of 23.41±19.476 years and a median age of 19 years.The course of disease ranged from 25 days to 58 years,with an average of 8.06±9.020 years.Skin lesions were found in 118 cases(17.51%)of the scalp,264 cases of the face(39.16%),69 cases of the neck(10.24%),93 cases of the trunk(13.80%),48 cases of the upper limbs(7.12%),51 cases of the lower limbs(7.57%),10 cases of the perineum(1.48%),and 21 cases of generalized hair(3.12%).Among them,at the exposed site(head,face,neck and upper limb)in 499 cases(74.03%)and at the unexposed site in 175 cases(25.97%).2.The clinical manifestations:Types of lesions primary lesions include plaques,macules,papules,plaques,blisters,nodules,cysts,secondary lesions include scab,erosion.The main manifestations 301 cases(44.65%),199 cases(29.53%)of plaques,73 cases(10.83%)of nodules,48 cases(7.12%)of cysts,21 cases(3.12%)of plaques,18 cases(2.67%)and 14 cases(2.08%)of blisters,and.Erosion and scab appeared on the surface of 41 cases.Conscious symptoms include itching,pain,itching,and no conscious symptoms.Among them,361 cases(53.57%)had no conscious symptoms,187 cases(27.74%)had itching,91 cases(13.50%)had pain,35 cases(5.19%)had itching,.3.The pathological classification:It can be divided into three categories according to the direction of differentiation:340 cases(50.45%)of differentiation towards sebaceous glands:214 cases(31.75%)of nevus sebaceous,117 cases(17.36%)of steatocystoma multiplex,2 cases(0.30%)of sebaceous adenoma,5 cases(0.74%)of sebaceoma,2 cases(0.30%)of sebaceous carcinoma;213 cases(31.60%)of hair follicle differentiation:40 cases(5.93%)of tricholemmoma,136 cases(20.17%)of pilomatrixoma,4 cases(0.59%)of dilated pore,6 cases(0.89%)of inverted follicular keratosis,4 cases(0.59%)of pilar sheath acanthoma,2 cases(0.30%)of trichoadenoma,2 cases(0.30%)of trichilemmal carcinoma,3 cases(0.45%)of trichofolliculoma,3 cases(0.45%)of folliculosebaceous cystic hamartoma,13 cases(1.93%)of trichoblastoma;121 cases(17.95%)of differentiation towards sweat glands:87 cases(12.90%)of syingoma,7 cases(1.04%)of apocrine hidrocystoma,9 cases(1.33%)of syringocystadenoma papilliferum,6 cases(0.89%)of mixed tumor of the skin,5 cases(0.74%)of eccrine hidrocystoma,2 cases(0.30%)of eccrine poroma,1 cases(0.15%)of eccrine porocarcinoma,1 cases(0.15%)of syningoid eccrine carcinoma,1 cases(0.15%)of primary mucinous carcinoma.4.Benign and malignant classification:a total of 667 cases(98.96%)were benign tumors.There were 7 malignant tumors(1.04%):2 cases(0.30%)of trichilemmal carcinoma,2 cases(0.30%)of sebaceous carcinoma,1 cases(0.15%)of eccrine porocarcinoma,1 cases(0.15%)of syningoid eccrine carcinoma,1 cases(0.15%)of primary mucinous carcinoma.Conclusions:1.From 2008 to 2018,the number of CAT diagnoses in our department has been on the rise.2.The ratio of men to women is 1:1.32.The proportion of women>men.CAT can occur at any age,with an average onset age of 23.13±19.711 years and a median age of 19 years.There was no statistical difference in the onset age of male and female patients.3.The distribution of skin lesions was 264 cases on the face>118 cases on the scalp>93 cases on the trunk>69 cases on the neck>51 cases on the lower extremities>48 cases on the upper extremities>21 cases with generalized symptoms>10 cases with perineum.Among them,there were 499 cases(74.03%)of exposed parts(head,face,neck,upper limbs)and 175 cases(25.97%)of non-exposed parts.The difference between the two was statistically significant,suggesting that the occurrence of CAT may be related to sun exposure and ultraviolet radiation4.The clinical manifestations were mostly non-specific,with 301 cases of papules>199 cases of plaques>73 cases of nodules>48 cases of cysts>21 cases of patches>18 cases of spots>14 cases of blisters.Conscious symptoms:361 cases without conscious symptoms>187 cases of itching>91 cases of pain>35 cases of itching and pain.Therefore,the clinical manifestations of CAT are lack of specificity,the self-perceived symptoms are not obvious.Therefore,clinical observation should be strengthened in clinical work,and histopathological examination should be timely improved to make a clear diagnosis.Clinical manifestations combined with histopathological features are essential for the correct diagnosis of CAT.5.The direction of differentiation CAT can be divided into hair follicle differentiation,sebaceous gland differentiation,and sweat gland differentiation.The proportion of sebaceous gland differentiation>hair follicle differentiation>sweat gland differentiation.6.The clinical diagnosis was consistent with the pathological diagnosis:of steatocystoma multiplex87 cases(74.36%)>nevus sebaceous134 cases(62.62%)>syingoma 41 cases>pilomatrixoma45 cases(33.09%)>mixed tumor of the skin>richoblastoma 2 cases(15.38%).Other diseases were misdiagnosed as other diseases,that is,the coincidence rate between clinical diagnosis and pathological diagnosis was 0%.7.Most of the common CAT have benign tumor biological behavior,but some may become malignant or merge with other malignancies.