皮肤CT在白癜风分期中的应用  

Application of Skin CT in Staging of Vitiligo

作　　者：王瑞[1] 王菲菲[1] 杨俊亚[1] 曹鸿玮[1] 郑晓红[1] WANG Rui;WANG Fei-fei;YANG Jun-ya(Department of Dermatology,theFifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450050,Henan Province,China)

机构地区：[1]郑州大学第五附属医院皮肤性病科,河南郑州450052

出　　处：《中国CT和MRI杂志》2018年第11期147-149,共3页Chinese Journal of CT and MRI

摘　　要：目的初步探讨皮肤CT在白癜风分期中的应用价值。方法选取2017年4月-2018年4月我院皮肤科收治的30例白癜风患者为研究对象,分别应用白癜风疾病活动度评分(VIDA)及皮肤CT特征进行白癜风分期,并分别选取5例进展期白癜风患者和5例稳定期白癜风患者,于皮肤CT检测部位行免疫组化染色分析。结果 30例患者,根据VIDA评分进行分期:快速进展期7例,缓慢进展期10例,稳定期13例;根据皮肤CT特征进行分期:快速进展期6例,缓慢进展期9例,稳定期15例,两种方法对白癜风分期比较差异无统计学意义(P>0.05)。皮肤CT图像特征为:进展期白癜风表现为白斑区基底层色素环失去完整性,残存色素环色素含量明显降低,与周围正常皮肤边界模糊不清,部分患者真皮浅层可见高折光性细胞;稳定期白癜风表现为基底层色素环完全缺失,与周围皮肤有清晰界限,皮损边缘正常色素环完整,部分患者皮损区毛囊周边有树突状黑色素。免疫组化显示,进展期白癜风皮损处有明显淋巴细胞浸润,稳定期白癜风皮损处无淋巴细胞浸润。结论皮肤CT可作为判断白癜风分期的重要手段,白癜风皮损处是否存在淋巴细胞浸润可作为区分白癜风进展期与稳定期的重要依据。Objective To preliminarily discuss the value of skin CT in the staging of vitiligo.Methods A total of thirty patients with vitiligo admitted to the department of dermatology of the hospital from April 2017 to April 2018 were selected as study subjects.The degree of activity of vitiligo(VIDA)score and skin CT features were used for staging of vitiligo.Five patients with progressive vitiligo and 5 patients with stable vitiligo were selected.The immunohistochemical staining was performed at sites examined by skin CT.Results The staging of VIDA score showed 7 cases in rapid progressive stage,10 cases in slow progressive stage and 13 cases in stable stage.The staging according to skin CT features showed 6 cases in rapid progressive stage,9 cases in slow progressive stage and 15 cases in stable stage.There was no significant difference in staging of vitiligo between the two methods(P >0.05).The characteristics of skin CT images were as follows.Progressive vitiligo manifested as loss of integrity of the basal pigment ring in the vitiligo area,obviously decreased content of pigments on residual pigment ring,blurred boundaries with normal skin and some patients with high refractive cells in the superficial dermis.Stable vitiligo manifested as complete loss of basal pigment ring,clear boundaries with the surrounding skin,intact normal pigment rings at edges of skin lesions and some patients with dendritic melanin around the hair follicles of skin lesions.Immunohistochemistry showed that there was significant lymphocytic infiltration of progressive vitiligo lesions but no lymphocytic infiltration of stable vitiligo lesions.Conclusion Skin CT can be used as an important method to judge the stage of vitiligo.The presence or absence of lymphocyte infiltration at lesions of vitiligo can be used as an important basis for distinguishing progressive and stable vitiligo.

关 键 词：白癜风 反射式共聚焦显微镜 病理学 分期 

分 类 号：R246.7[医药卫生—针灸推拿学]