胯下紅疹似濕疹拖一年求醫 50歲男患癌延醫脊椎被侵蝕

胯下紅疹似濕疹拖一年求醫 50歲男患癌延醫脊椎被侵蝕

台灣一名壯年男子出現胯下痕癢，但由於患處位於生殖器附近，男子怕尷尬不敢求醫，1年後做檢查始發現患上皮膚癌，而男子因延誤治療導致癌細胞擴散，3分之1的脊椎骨被侵蝕。有臨床腫瘤科專科醫生表示，此皮膚癌病徵與濕疹相似，難靠肉眼分辨，若搽類固醇藥膏仍未有改善，宜盡快做檢查。

胯下出疹羞求醫 一年後揭患癌

據台媒報道，當地一名年約50歲男子運動後出現胯下痕癢、破皮、紅疹等症狀，但由於患處位於生殖器附近，事主因不好意思求醫遂自行擦藥膏，1年後情況未見好轉，到醫院檢查始發現患上乳房外柏哲德氏病（Extramammary Paget's Disease），但因延誤治療，汗腺細胞已突變為癌細胞，並順淋巴擴散附在器官與骨頭上，影像檢查發現有3分1脊椎骨都被侵蝕。

症狀與濕疹相似

主治的皮膚科醫生江建平表示，乳房外柏哲德氏病屬皮膚癌的一種，可分為原發型及繼發型，前者源自皮膚大汗腺細胞病變；後者則是因病患患有其他器官癌症之皮膚轉移。疾病好發於汗腺較發達部位，如腋下、胯下、生殖器肛門口周圍皮膚，外觀似濕疹、股癬，初期會出現局部搔癢、疼痛症狀，之後患處會漸漸擴大，甚至出現隆起、組織液滲出、潰瘍等狀況。若患者延誤治療，可導致淋巴結或遠端器官轉移。

Doctors thought he just had jock itch. Then it spread.

Doctors thought he just had jock itch. Then it spread.

Late Friday afternoon on Dec. 4, 2014, Stephen Schroeder was waiting to board his packed flight from Philadelphia to Las Vegas for a much anticipated long weekend with his son when his cellphone rang. On the line was an unexpected caller: his doctor, reporting test results sooner than Schroeder had expected.

Listening intently, Schroeder was flooded with disbelief as he struggled to comprehend what he was hearing. Using the lip of a trash can as a writing surface, he scribbled notes on the back of his boarding pass, making the doctor spell out each unfamiliar word. Then he sent a terse text to his wife, who was at their home in the Philadelphia suburbs, and got on the plane.

Onboard, Schroeder, then 55, fired up the balky in-flight Internet, desperate for information.

What he read over the next five hours left him alternately terrified, stunned and then, as denial took over, skeptical. “I kept thinking this must be some kind of really stupid mistake,” he recalled. “The diagnosis had to be wrong.”

胯下好癢可以到藥房買成藥嗎？醫生提醒：小心擦出問題！

胯下好癢可以到藥房買成藥嗎？醫生提醒：小心擦出問題！

臺北市立聯合醫院和平婦幼院區皮膚科醫師李孟穗表示，胯下癢是皮膚科門診中常見的求診症狀，常見的發作部位包括大腿內側或股溝處，或是女性私密處、男性陰囊等。

「胯下癢發作時會搔癢無比，讓人坐立難安，不抓難受，抓了又不雅觀，但由於病灶在隱私部位，不少病患不願意就醫，而選擇自行到藥局購買外用藥膏來塗抹，結果常因擦了不適當的藥膏，造成病情惡化時，才向醫師求助，」李孟穗指出。

李孟穗表示，很多皮膚病都會出現胯下癢的情形，可能是黴菌或細菌、病原蟲感染造成的，也可能因皮膚受到持續摩擦刺激，再加上衣褲包覆悶熱導致，包括：股癬、念珠菌感染、紅癬、疥瘡、陰蝨、濕疹、對磨疹或少見的乳房外柏杰氏病(Extramammary Paget’s disease, EMPD)等疾病。

冬天也會"胯下癢"! 自行買錯藥皮膚恐變薄

冬天也會"胯下癢"! 自行買錯藥皮膚恐變薄

台北市立聯合醫院和平婦幼院區皮膚科主任李孟穗表示，胯下癢大多好發在大腿兩側、股溝處、女性私密處、男性陰囊等部位，發作時奇癢無比，不過，因為發病位置通常較隱私，所以不少病患害羞不想就醫，自行到藥局購買外用藥膏來塗，結果用藥不對，病情惡化時，才向醫師求助。

李孟穗指出，很多皮膚病都會出現胯下癢的情形，可能是黴菌、細菌、病原蟲感染造成的，也可能是皮膚受到持續摩擦刺激，再加上衣褲包覆悶熱導致，包括股癬、念珠菌感染、紅癬、疥瘡、陰蝨、濕疹、對磨疹或少見的乳房外柏杰氏病(Extramammary Paget's disease, EMPD)等疾病。

Living with a rare skin disease

Living with a rare skin disease

David Kendall shares his story

David Kendall has Extramammary Paget’s disease (EMPD), a rare cancer-related condition which is characterised externally by a chronic eczema-style rash of the skin in the anogenital regions or as is the case with David, the groin area.

Doctors described David’s EMPD case as “one in a million” due to its rarity, with the result being that he has found it difficult to access definitive information about it online.

Il morbo di Paget extramammario

Il morbo di Paget extramammario

Il morbo di Paget extramammario è una neoplasia spesso non diagnosticata clinicamente e che deve essere conosciuta per poterla porre in diagnosi differenziale. Si tratta istologicamente di un carcinoma intraepidermico a differenziazione ghiandolare apocrina, di solito localizzato in aree ove sono presenti ghiandole sudoripare.

East Kilbride family man takes on Men's 10K on Father's Day for charity based on his own experiences with skin cancer

East Kilbride family man takes on Men's 10K on Father's Day for charity based on his own experiences with skin cancer

An East Kilbride dad will take on a charity 10K on Father’s Day as he bids to raise money based on his own experiences with skin cancer. 

Dad-of-two David Kendall (57), who suffers from a skin condition called Extramammary Paget’s disease (EMPD), hopes his efforts will boost the funds of the British Skin Foundation by £1000.

The illness is a rare cancer-related condition which is characterised externally by a chronic eczema-style rash of the skin in the anogenital regions, and in David’s case, the groin area.

Jangan Anggap Remeh Gatal-Gatal Di 5 Area Vital Laki-Laki Ini

Jangan Anggap Remeh Gatal-Gatal Di 5 Area Vital Laki-Laki Ini

Skrotum atau area kulit testis, atau lebih awam dikenal dengan istilah area buah zakar, kerap juga menjadi sasaran keluhan gatal pada area alat vital pria. Berikut beberapa pencetus keluhan gatal pada area buah zakar:

- Eksim: merupakan suatu penyakit kulit kronis yang ditandai dengan gatal, peradangan dan kemerahan pada kulit

- Extramammary Paget’s disease: merupakan suatu keganasan kulit pada kulit skrotum yang terlihat serupa dengan eksim.

Penting diketahui, karena kondisi gatal yang muncul pada area skrotum seringkali kronis (menahun) jangan menunda untuk melakukan pemeriksaan untuk pengobatan.

Jangan Sepelekan Gatal di Sekitar Kemaluan Pria!

Jangan Sepelekan Gatal di Sekitar Kemaluan Pria!

Skrotum atau area kulit testis, atau lebih awam dikenal dengan istilah area buah zakar, kerap juga menjadi sasaran keluhan gatal pada area alat vital pria. Berikut beberapa pencetus keluhan gatal pada area buah zakar:

  • Eksim: merupakan suatu penyakit kulit kronis yang ditandai dengan gatal, peradangan dan kemerahan pada kulit

  • Extramammary Paget’s disease: merupakan suatu keganasan kulit pada kulit skrotum yang terlihat serupa dengan eksim.

Penting diketahui, karena kondisi gatal yang muncul pada area skrotum seringkali kronis (menahun) jangan menunda untuk melakukan pemeriksaan untuk pengobatan.

MSK Researchers Develop Targeted Test for Mutations in Both Rare and Common Cancers

MSK Researchers Develop Targeted Test for Mutations in Both Rare and Common Cancers

Building on our rich history of innovation, genome scientists, bioinformaticians and molecular pathologists at Memorial Sloan Kettering Cancer Center have developed a targeted tumor sequencing test, MSK-IMPACT™ (Integrated Mutation Profiling of Actionable Cancer Targets), to detect gene mutations and other critical genetic aberrations in both rare and common cancers. Until now, genomic testing of tumors has been routine practice only for patients with certain solid tumors, such as melanoma, lung, and colon cancer. MSK-IMPACT™ is much more inclusive and can be used on any solid tumor regardless of its origin, potentially offering better treatment options for thousands of patients in the form of precision oncology

Extramammary Paget's Needs More Than Mohs

Extramammary Paget's Needs More Than Mohs

Extramammary Paget’s disease poses a particular challenge because of its multifocal/multicentric nature.

"What you see with extramammary Paget’s is not necessarily what you get," Dr. Theodore Rosen cautioned at the Hawaii Dermatology Seminar sponsored by Skin Disease Education Foundation (SDEF).

This is an uncommon neoplasia that’s typically described as an erythematous, erosive, itchy patch or plaque having a strawberries-and-cream appearance. Yet there may be other areas of subclinical involvement at a distance from the obvious lesion. 

YouTube Video: https://www.youtube.com/watch?v=WmMnODBDUPY

Immunostaining Can Help Classify Paget Disease

Immunostaining Can Help Classify Paget Disease

EMPD is an uncommon condition occurring primarily in the elderly, with more women than men affected. It arises as a cutaneous adenocarcinoma with a proclivity for sites rich in apocrine glands. Patients with EMPD often present with a prominent solitary plaque lesion in the anogenital or vulvar region. The lesion is erythematous, eczematous, and often pruritic. The course is often locally aggressive, with frequent recurrences.

What Caused this Patient’s Groin Itch?

What Caused this Patient’s Groin Itch?

Case Presentation A 67-year-old white man presented with a 6-month history of a slowly increasing in size, slightly pruritic, erythematous rash in his right lower abdominal quadrant extending to his inguinal fold and right side of his scrotum. He reported having a similar lesion in his right axilla 7 years earlier that was surgically excised with no clinical evidence of recurrence. Otherwise, he was healthy with no history of systemic diseases. On examination there was an 8-cm by 6-cm erythematous, slightly elevated, papillomatous plaque extending from his right pubic area to the right lateral scrotal wall. No alopecia was noted overlying the plaque. No inguinal lymphadenopathy was appreciated on nodal examination. A well-healed scar was present in the right axilla, but no axillary adenopathy was noted. A KOH preparation of the lesion was negative for hyphae. Histologic examination of a 4-mm punch biopsy specimen taken from the inguinal plaque revealed an atypical cellular proliferation composed of clear cells ascending through the epidermis. These cells were positive for carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA) and mucicarmine stains. The S-100 stain did not stain these cells. What’s Your Diagnosis? Turn to page 98 for an answer and for more details.

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