皮肤镜在尖锐湿疣诊断中的价值评估  

Application value of dermoscopy in the diagnosis of condyloma acuminatum

作　　者：张云杰[1] 邹先彪[1] 郭晓娟[1] 林卉[1] Zhang Yunjie Zou Xianbiao Guo Xiaojuan Lin Hui(Department of Dermatology, First Affiliated Hospital of PLA General Hospital, Beijing 100048, China)

机构地区：[1]解放军总医院第一附属医院皮肤科,北京100048

出　　处：《中华皮肤科杂志》2017年第7期493-496,共4页Chinese Journal of Dermatology

基　　金：国家自然科学基金（61308117）;解放军总医院临床科研扶持基金（2015FC-TSYS-3045）

摘　　要：目的 探讨皮肤镜在男性生殖器部位尖锐湿疣诊断中的应用价值。方法 对66例男性生殖器部位临床疑似尖锐湿疣的122个疣体，由临床经验丰富的皮肤科医师根据皮损形态特征结合临床病史进行临床诊断，然后采用皮肤镜进行诊断，并与组织病理检查结果比较。结果 122个疑似疣体中，采用肉眼观察确诊100个为尖锐湿疣，皮肤镜检查确诊112个，病理检查确诊114个。以病理检查为金标准，皮肤镜检查的灵敏度是97.4%，特异度是87.5%；肉眼观察的灵敏度是87.7%，特异度是100%。在皮肤镜下男性生殖器部位尖锐湿疣颜色主要呈粉红色（98/114，86.0%），形态以乳头状多见（98/114，86.0%），有明显的血管特征（107/114，93.9%），其中多形血管（102/114，89.5%）和点状血管（98/114，86.0%）多见。结论 皮肤镜下尖锐湿疣疣体具有特征性结构，皮肤镜能够用于男性生殖器尖锐湿疣诊断。Objective To evaluate the application value of dermoscopy in the diagnosis of genital eondyloma acuminatum （CA） in men. Methods A total of 122 warts from 66 male patients with suspected genital CA were firstly diagnosed by experienced dermatologists according to macroscopic morphological characteristics of lesions and clinical history of patients. Afterwards, the warts were examined and diagnosed by dermoseopy, and the two diagnosis results were compared with histopathological findings. Results Of 122 suspected warts, 100 were diagnosed as CA by naked-eye examination, 112 as CA by dermoscopy and 114 as CA by pathological examination. When histopathological findings served as the gold standard, dermoscopy had a sensitivity of 97.4% and a specificity of 87.5%, and nakedeye examination had a sensitivity of 87.7% and a specificity of 100%. Under dermoseopy, most male genital warts were pink （98/114, 86.0%） and papillary （98/114, 86.0% ）, and had distinct vascular characteristics （ 107/114, 95.5% ）, which mainly included pleomorphie vessels （102/114, 89.5% ） and punctate vessels （98/114, 86.0%）. Conclusion CA has characteristic structures under dermoseopy, so dermoseopy can be used for the diagnosis of genital CA in men.

关 键 词：尖锐湿疣 皮肤镜检查 病理过程 诊断 

分 类 号：R752.53[医药卫生—皮肤病学与性病学]