I really had a strange disease, went to many hospitals, saw dermatology every time, but never looked good.
Talking about her own disease experience, 49-year-old Ms. Yu sighed with emotion, people will meet many doctors in this life, but as long as they meet a good doctor who is careful and responsible, it is enough.
Ms. Yu said that every time she visited the doctor, the doctor would ask two random questions, then look at her skin, write a medical record, prescribe some medicine and send her away, and even went to see experts from provincial hospitals.
After this hospitalization, Ms. Yu said that she had lost a lot of weight in the past month, so she was admitted to the gastroenterology department, and the doctor conducted a detailed physical examination for me, and found that I had swollen lymph nodes in my groin on both sides, and the biopsy confirmed that it was malignant lymphoma.
The doctor told me that lymphoma can also cause itchy skin, and many patients with lymphoma, in addition to itchy skin, have no other symptoms, especially patients with Hodgkin lymphoma, who are more likely to have itchy skin. The main reason for itchy skin is that tumor cells can produce biologically active substances such as histamine, which are transported to nerve endings with the flow of blood to stimulate itching of the skin.
Unfortunately, this symptom is easy to be misdiagnosed, many dermatologists will only see whether the patient has a rash, as for a more detailed physical examination, they will not do it again, and the outpatient volume of dermatology is too large, doctors do not have enough time for every patient, and the larger the hospital may be more so, so often three words, quickly send the patient away.
If Ms. Yu had not been hospitalized this time, the cause of her itchy skin might still not have been found.
As a doctor, I want to remind everyone that many people may be plagued by a variety of skin diseases, the skin is the largest organ of the human body, although it is located on the surface of the body, but many internal organs may cause skin abnormalities when there are lesions, so sometimes skin diseases are not so simple.
First, skin itching, foreign literature shows that about 16~30% of malignant lymphoma patients, 25% of genital organ cancer patients, 25~60% of cancer elderly women and 50% of rectal cancer cancer patients, there will be different degrees of itching. Unfortunately, although many people suffer from itchy skin, they do not take it seriously at all, and even many doctors take it for granted.
Second, malignant acanthosis nigricans, in specific parts of the brown to gray pigmented, papillomatomatous keratotic lesions, this is the typical manifestation of acanthosis nigricans, acanthosis nigalenis is divided into benign and malignant diseases, benign acanthosis nigricans can be accompanied by pituitary, adrenal and ovarian tumors, often in adolescence. Malignant acanthosis nigricans is almost always associated with visceral tumors. About 60% of the patients' skin symptoms progress synchronously with the degree of internal organ malignancy, about 20% of the patients' skin symptoms precede the malignant tumor by several years, and about 20% of the patients' malignant tumor is primary, and the skin disease is secondary.
Third, malignant melanoma, its typical manifestation is pigmented skin lesions in months or years of obvious changes, can appear bleeding, itching, tenderness, ulcers and other symptoms of one or more, many people are difficult to distinguish between moles and melanoma, the two diseases are completely different, the prognosis is also different, once the melanoma is mistaken for a mole, the result will be very tragic, the movie "Do not disturb" in Sun Honglei played by Li Xiangshan has an "incurable disease", the black mole on the instep becomes melanoma, which makes many people uneasy for a while.
How to tell whether a mole on the skin is benign or malignant, there is the ABCDE rule, Asymmetry (asymmetry): asymmetry on both sides. Border: The borders or edges of irregular nevi are uneven, blurred or jagged. Color: If a mole has more than one color, it is considered abnormal, including darkening or lightening. Diameter: A mole is considered abnormal if it is larger than an eraser (about 1/4 inch or 6 mm). Evolution: Progress refers to any change in symmetry, border, color, and diameter of an already existing mole.
Fourth, dermatomyositis, is a non-purulent inflammatory lesion mainly involving the rhabdomyotic muscle, mainly lymphocyte infiltration, which can be accompanied by a variety of skin lesions. Dermatomyositis has a variety of cutaneous manifestations. Among them, there is a diagnostic specific Gottron maculopapular rash. It is commonly found in metacarpophalangeal joints, interphalangeal joints, elbows, knees and other joint extensors, as well as shoulders, hips and other parts that are susceptible to friction. Although dermatomyositis is a rheumatic immune disease, it is closely related to cancer. About 20% of patients with dermatomyositis will have complications, including lung cancer, bone cancer, spine cancer, prostate cancer, and gynecologic tumors, especially gynecologic tumors and lung cancer.
The reason why cancer causes skin changes mainly includes direct invasion and spread and skin metastasis, skin metastasis refers to the tumor through blood circulation, lymphatic circulation metastasis, tissue space spread secondary to the skin lesions, usually the manifestation of advanced cancer.
In order to avoid skin abnormalities caused by cancer being misdiagnosed or missed, as doctors and patients must make efforts, doctors' thinking can not be too limited, treat patients more meticulously and responsibly, can not mainly rely on eyes and consultation, but also need to rely on a comprehensive physical examination, patients abnormalities can not be ignored, for any abnormal signals, even if it is very light should communicate with the doctor in time, can not be hidden, if the drug prescribed by the doctor does not improve, should also communicate with the doctor in time, if the doctor recommends a comprehensive examination, Be sure not to refuse, don't think it's a skin disease, what is there to check!