【摘要】 患者女，78岁，右面部多发红斑伴脱屑、瘙痒3年，加重半年。体查：右颞部、颊部、鼻部及额部多发暗红斑片、斑块，覆黏着性鳞屑及黄褐色痂，面部皮肤见毛细血管扩张、砂纸样改变伴色沉。诊断：光化性角化病(区域癌化型)。治疗：予盐酸氨基酮戊酸散光动力区域化治疗，在两次治疗后原有皮损大多消退的情况下，右颧部出现新发光化性角化病皮损。参考治疗前荧光诊断照片可见右颧部微弱的砖红色荧光与新发皮损位置吻合，遂继续完成后两次光动力治疗。4次治疗后患者原有皮损及新发皮损均消退，面部光老化得到改善，持续随访1年未见皮损复发和显著不良反应。更多还原

【Abstract】 A 78-year-old female patient presented with multiple erythema with scaling and pruritus on her right face for 3 years, worsening over the past 6 months. Physical examination revealed multiple dusky red patches and plaques on the right temple, cheek, nose, and forehead, covered with adherent scales and yellowish-brown crusts. Facial skin also showed telangiectasia, sandpaper-like texture changes, and hyperpigmentation. Histopathological examination confirmed the diagnosis of actinic keratosis(AK). The diagnosis was AK(field cancerization). The patient was treated with field-directed aminolevulinic acid photodynamic therapy(ALA-PDT). After two treatments, while most of the original lesions had resolved, a new AK lesion appeared on the right zygomatic area. Reviewing the pre-treatment fluorescence diagnostic photos revealed a faint brick-red fluorescence in the right zygomatic area, corresponding with the location of the new lesion. The remaining two PDT treatments were subsequently completed. After 4 treatments, both the original and new lesions resolved, and the facial photoaging improved. Follow-up for 1 year showed no recurrence of lesions or significant adverse reactions.更多还原