摘要
目的:建立皮肤镜对白癜风、白色糠疹、无色素痣、炎症后色素减少症、进行性斑状色素减少症、老年性白斑和贫血痣的临床图像特征分析技术。方法:分别观察1439例色素减退性疾病患者的皮损,用皮肤镜观察肉眼不可见的细微结构,如背景颜色、血管形态、边界情况、毛发及毛囊是否异常等。应用卡方检验和Fisher精确检验方法进行统计学分析。结果:瓷白色、花斑色和浅白色背景色度分别为白癜风稳定期、无色素痣和进行性斑状色素减少症的较特异性皮肤镜图像特征。灰白色糠状鳞屑是白色糠疹的特异性皮肤镜图像特征,可区别于其他疾病。进展期白癜风特征为乳白色背景,边界模糊,毛囊周围色素残留,周边点状、不规则状色素减退斑,斑片状色素残留。稳定期白癜风特征为瓷白色背景,边界清晰,毛囊周围色素残留,皮损周围色素加深。恢复期白癜风特征为边界清晰,毛囊周围色素残留,皮损周围色素加深,易见色素岛。白色糠疹特征为淡黄白色背景,表面细小或片状灰白色糠状鳞屑,边界模糊。无色素痣:花斑样背景,边界模糊,斑片状色素残留。炎症后色素减少症特征为黄白色背景,边界模糊。进行性斑片状色素减少症特征为浅白色背景,边界模糊。老年性白斑特征为乳白色背景,边界清晰。贫血痣特征为黄白色背景,边界模糊,摩擦后周边呈现网格状血管分布。结论:皮肤镜临床图像特征分析技术可作为诊断和鉴别诊断白癜风、白色糠疹、无色素痣、炎症后色素减少症、进行性斑状色素减少症、老年性白斑和贫血痣的一种辅助方法。
Objective： The establishment of a technique for analyzing microscopic imaging characterics of vitiligo, pityriasis alba, amelanotic nevus, postinflammatory hypomelanosis, progressive macular hypomelanosis, senile guttate leukoderma and nevus anemicus, Methods： Dermoseope was used to observe fine structures which are invisible by naked eyes, including background colin, vascular morphology, features of lesional borders, hair and hair follicles, in 1439 subjects with hypopigmentation disorders. Statistical analysis was performed using chi-square and Fisher＇s exact tests. Results： The background color of porcelain white, piebald and light white represented dermoseopic characterics of stable vitiligo, amelanotic nevus and progressive macular hypomelanosis, respectively. Off white bran-like scales specifically distinguished pityriasis alba from other diseases. Progressive vitiligo was characterized by ivory white background, fuzzy boundaries, residual pigment around the hair follicles, lesions surrounded by point-like and irregular hypopignlented spots, and patchy residual pigment. In contrast, stable vitiligo was characterized by porcelain white background, elear boundaries, residual pigment around the hair follicles, and hyperpigmentation around the lesions. Likewise, regression vitiligo was also characterized by clear boundaries, residual pigment around the hair follicles, pigment islands, and hyperpigmentation around the lesions. Light yellow-white background with small or flaky off white bran-like scales on the surface of the lesions, and fuzzy boundaries were the characteristics of pityriasis alba. Piebald-like background with fuzzy boundaries, and patchy residual pigment were the characteristics of amelanotic nevus. Yellow-white background and fuzzy boundaries were specific features of postinflammatory hypomelanosis. Light white background and fuzzy boundaries were the characteristics of progressive macular hypomelanosis. Ivory white background with clear boundaries was the characteristic of senile guttate leukoderma. Yellow-white background, fuzzy boundaries, and appearance of reticulated vascular pattern around lesion were specific features of nevus anemicus. Conclusions： Analysis of dermoscopic images can be used as an accessory method for diagnosis and differential diagnosis of vitiligo, pityriasis alba, amelanotic nevus, postinflammatory hypomelanosis, progressive macular hypomelanosis, senile guttate leukoderma and nevus anemicus.
出处
《临床皮肤科杂志》
CSCD
北大核心
2017年第6期401-405,共5页
Journal of Clinical Dermatology
基金
国家自然科学基金(81472887)资助项目
关键词
皮肤镜
色素减退性皮肤病
临床图像特征
分析技术
dermoscopy
hypopigmentation skin disorders
clinical imaging feature
analytical techniques
