不同病理亚型黑素细胞痣皮肤镜特征探究  

Investigation of Dermoscopic Features of Different Pathological Subtypes in Melanocytic Nevi

作　　者：陈立勇 陈柳青[1] 陈红英[1] CHEN Liyong;CHEN Liuqing;CHEN Hongying(Department of Dermatology,the First Hospital of Wuhan,Wuhan 430022,China)

机构地区：[1]武汉市第一医院皮肤科,湖北武汉430022

出　　处：《中国皮肤性病学杂志》2020年第8期888-893,共6页The Chinese Journal of Dermatovenereology

摘　　要：目的探究不同病理亚型黑素细胞痣(melanocytic nevi,MN)皮肤镜下的模式与结构特征差异。方法收集2016年5月-2019年5月在武汉市第一医院就诊的175例经组织病理确诊的MN患者皮肤镜影像及组织病理资料,比较不同病理亚型MN在皮肤镜模式与局部结构特征等方面的差异。结果三种亚型MN在网状模式、球状模式、鹅卵石状模式、平行沟模式、纤维样模式、豆荚样模式、血管结构、小球样结构、鹅卵石样结构、多区域色素减退、粉刺样开口等方面差异具有统计学意义。交界痣最常见的模式是平行沟模式(23.08%)、其次为纤维样模式(13.46%)、网状模式(11.54%)等。复合痣常见特征出现频率依次为球状模式(34.92%)、混合模式(23.81%)、鹅卵石状模式(15.87%),常见的结构为小球样结构(63.49%)。皮内痣常见特征依次为鹅卵石状模式(55.00%)、非典型模式(18.33%)、混合模式(16.67%)、鹅卵石样结构(68.33%)、多区域色素减退(65.00%)及粉刺样开口(41.67%)。在皮肤镜模式层面,交界痣以平行沟模式为典型特征,复合痣以球状模式为典型特征,而皮内痣以鹅卵石状模式为典型特征;在局部结构层面,小球样结构是复合痣的主要特征,鹅卵石样结构与多区域色素减退为皮内痣主要特点。结论三种病理亚型MN皮肤镜模式与结构特征具有一定的交叉,但它们又有各自典型的模式与结构特征。根据MN的皮肤镜特征,有助于临床提高诊断MN的准确性。Objective To investigate the dermoscopic patterns and local structures of distinct pathological subtypes in melanocytic nevi(MN).Methods One hundred and seventy-five dermoscopic cases of histopathologically confirmed MN were collected from May 2016 to May 2019 in The Fisrt Hospital of Wuhan.The images were evaluated for the global patterns and local structures.Results The primary differences of dermoscopic patterns and local structures of the three types of MN were a reticular pattern,a globular pattern,a cobblestone pattern,a parallel furrow pattern,a fibrillar pattern,vascular structures,cobblestone structures,globular structures,multifocal hypopigmentation and comedo-like openings.The most frequent patterns of junctional nevi were a parallel furrow pattern(23.08%),followed by a fibrillar pattern(13.46%),and a reticular pattern(11.54%).The most common features of compound nevi were a globular pattern(34.92%),a mixed pattern(23.81%),a cobblestone pattern(15.87%)and globular structures(63.49%).Intradermal nevi were primarily typified by a cobblestone pattern(55.00%),a atypical pattern(18.33%),a mixed pattern(16.67%),cobblestone structures(68.33%),multifocal hypopigmentation(65.00%)and comedo-like openings(41.67%).In terms of dermoscopic patterns,junctional nevi were characterized by a parallel furrow pattern;compound nevi were typified by a globular pattern;intradermal nevi featured a cobblestone pattern.In terms of local structures,the globular structures were the main feature of compound nevi,while cobblestone structures and multifocal hypopigmentation were the primary characteristics of intradermal nevi.Conclusion The three pathological subtypes of MN overlap to some extent in dermoscopic patterns and local structures,but they have their own typical patterns and structural characteristics.Based on the dermoscopic features of MN,dermoscopy can significantly improve the clinical diagnostic accuracy of MN.

关 键 词：皮肤镜 黑素细胞痣 病理亚型 

分 类 号：R739.5[医药卫生—肿瘤]