针扎伤皮损的皮肤镜征象分析  

Dermoscopic Features of Needle Injury

作　　者：罗莉[1,2] 李灵 巩毓刚[1] 卢葳[1] 赵蓓[1] 沈柱[1] LUO Li;LI Ling;GONG Yugang;LU Wei;ZHAO Bei;SHEN Zhu(Department of Dermatology,Institute of Dermatology and Venereology,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China;The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]四川省医学科学院·四川省人民医院,皮肤病性病研究所,四川成都610072 [2]成都医学院第一附属医院,四川成都610500

出　　处：《中国皮肤性病学杂志》2021年第1期42-47,共6页The Chinese Journal of Dermatovenereology

基　　金：通信作者:巩毓刚,E-mail:[e-mail]。

摘　　要：目的目前国内外尚未见针扎伤皮损皮肤镜征象的报道,本研究通过观察针扎伤皮损的皮肤镜征象,为针扎伤提供诊断及鉴别诊断依据。方法使用血糖采血针在44例成人手背正常皮肤随机针刺一次,使用皮肤镜连续动态观察针扎皮损第1~5天同一时间点的镜下特征。结果针扎伤皮损的皮肤镜征象主要为中央凹陷,周边呈唇样隆起,早期还可表现为线状出血、红晕、线状裂隙、鳞屑、血痂形成,恢复期表现为血痂大部分脱落,红晕大部分消退,线状裂隙大部分愈合,遗留色素沉着和鳞屑。线状出血、红晕是早期诊断针扎伤的敏感性指标,而特异性指标为中央凹陷和周边唇样隆起。结论临床上可将皮肤镜作为诊断针扎伤的有效手段之一。线状出血、红晕等征象可以作为皮肤镜诊断针扎伤的初筛指标,而中央凹陷、周边唇样隆起是皮肤镜诊断针扎伤的特异性征象。Objective To observe dermoscopic features in lesions of needle injury and offer references to diagnosis or differential diagnosis of needle injury.Methods Normal skin on the dorsal aspects of hands from 44 adult people was randomly pinpricked once by a blood glucose needle.A total of 44 lesions were continuously subjected to dermoscopy from the first day to the fifth day.Results The basic dermoscopic features of needle injury lesions were central depression and peripheral lip-like apophysis.The early phase could also manifest as linear hemorrhage,blush,linear crack,scale,and formation of blood scabs.During the recovery period,most of blood scabs had fell off,most of blushes had faded,the majority of linear cracks had healed,leaving pigmentation and scales.Linear hemorrhage and blush were the most sensitive indicators in early diagnosis of needle injury,and the specific indicators were central depression and peripheral lip-like apophysis.Conclusion Dermoscopy is an effective,noninvasive diagnostic method to needle injury.Linear hemorrhage and blush are highly sensitive and can be used as the preliminary screening marker.Existence of central depression and peripheral lip-like apophysis can confirm the diagnosis of needle injury.

关 键 词：针扎伤 皮肤镜 鉴别诊断 

分 类 号：R751.05[医药卫生—皮肤病学与性病学]