点滴型银屑病反射式共聚焦激光扫描显微镜和皮肤镜图像特征  

Analysis of the Image Features of Guttate Psoriasis by Dermoscopy and the Reflection Confocal Microscope

作　　者：秦朋[1] 刘永斌[1] Qin Peng;Liu Yongbin(Shenyang Seventh People's Hospital,Shenyang 110013,China)

机构地区：[1]沈阳市第七人民医院,辽宁沈阳110013

出　　处：《中国中西医结合皮肤性病学杂志》2020年第4期333-336,共4页Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine

摘　　要：目的观察点滴型银屑病在反射式共聚焦激光扫描显微镜(RCM)和皮肤镜下的图像特征,为诊断及鉴别点滴型银屑病提供参考依据。方法选取组织病理学确诊的32例点滴型银屑病患者和30例斑块型银屑病患者,每例选1处皮损行RCM及皮肤镜检查,记录并统计各项图像特征。结果点滴型银屑病RCM下主要特征为角化过度、角化不全、Munro微脓肿、颗粒层变薄或缺如、棘层增厚、真皮乳头内毛细血管迂曲扩张、基底细胞层液化、真皮乳头层炎性细胞浸润等。其中Munro微脓肿及基底细胞层液化,在点滴型银屑病中发生率明显高于斑块型银屑病(P<0.05);银屑病增生模式在点滴型银屑病中发生率低(P<0.05)。点滴型银屑病皮肤镜下主要表现为低倍镜下亮红色背景、白色鳞屑、血管多种排列模式(点/球状、点/球+线状、短棒状血管);高倍镜下发夹样/环状、肾小球状血管。其中短棒状血管及血管灶性分布在点滴型银屑病中更常见(P<0.05)。结论RCM和皮肤镜可作为点滴型银屑病的无创检测方法。Objective In order to investigate the imaging features of reflectance confocal microscopy(RCM)and dermoscopy in patients with guttate psoriasis,and to provide references for the diagnosis and differential diagnosis of guttata psoriasis.Methods Thirty-two patients with guttate psoriasis and thirty patients with plaquepsoriasis confirmed by histopathology were selected.One lesion of each patient was examined by RCM and dermoscopy.The image characteristics were recorded and counted.Results The main characteristics of guttate psoriasis by RCM were hyperkeratosis,parakeratosis,Munro microabscess,diminished or disappeared stratum granulosum,acanthosis,dilated and tortuous capillaries in dermal papillae,liquefaction of basal cells and inflammatory cells in the dermis papillae.The incidence of Munro microabscess and liquefaction of basal cells in guttate psoriasis was significantly higher than that in plaque psoriasis(P<0.05),and the incidence of psoriasis proliferative pattern was lower in guttate psoriasis(P<0.05).The main manifestations of guttate psoriasis by dermoscopy were red background,white scales,multiple arrangement patterns of blood vessels(punctate/globular vessels,punctate/globular+linear vessels and short rod-like vessels)at low magnification.At high magnification,hairpin-like/annularand glomerular vessels could be seen.Short rod-like vessels and focal distribution of blood vessels were more common in guttate psoriasis(P<0.05).Conclusion RCM and dermoscopy can be used as non-invasive detection methods for psoriasis drip.

关 键 词：点滴型银屑病 共聚焦激光扫描显微镜 皮肤镜 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]