进行性斑状色素减少症30例临床分析

Clinical analyses of 30 cases of progressive macular hypomelanosis

目的:探讨进行性斑状色素减少症的临床特点并对其治疗情况进行分析。方法:回顾性分析我院于2013年10月-2018年10月间诊治的30例进行性斑状色素减少症患者的临床表现和治疗情况。结果:进行性斑状色素减少症主要的临床表现为躯干部出现边界不清的圆形、无鳞屑的色素减退斑,中央可发生融合。真菌镜检阴性。伍德氏灯:色素减退皮损区可见点状红色荧光。皮肤共聚焦扫描显微镜:色素环均正常,25例色素颗粒减少。30例患者均经过10周外涂异维A酸红霉素凝胶联合1周2次窄谱中波紫外线照射治疗,10例痊愈,7例基本治愈,7例显效,3例有效,3例无效,显效率为80.00%。结论:进行性斑状色素减少症临床表现轻微,无明显自觉症状,缺乏特异性的实验室检查,易被忽略及误诊。外涂异维A酸红霉素凝胶联合窄谱中波紫外线照射治疗疗效较好,且无严重的系统性不良反应发生,值得在临床上推广。

Objective:To explore the clinical characteristics of progressive macular hypomelanosis and its treatment.Methods:Retrospective analyses of the clinical manifestations and treatment efficacy were made in 30 patients with progressive macular hypomelanosis from October 2013 to October 2018.Results:The main clinical manifestations of progressive macular hypomelanosis were unclear rounded and scaleless hypopigmented macules,with some merge at the center,on the trunks.Microscopic examination for fungi was negative.Spotted red fluorescence on the hypopigmented lesion was visible under the wood lamp.Under confocal scanning microscope,normal pigment rings in all cases and reduced pigment particles in 25 cases were observed.Following 10-week treatments with isotretinoin-erythromycin gel combined with NB-UVB(narrow-band ultraviolet B)radiation twice a week,total effective rate was 80.00%,including 10 cured,7 almost cured,7 markedly improved,3 improved and 3 unimproved.Conclusions:Because progressive macular hypomelanosis is asymptomatic,with minimal clinical manifestations and without specific laboratory examination,it can be easily neglected or misdiagnosed.Topical isotretinoin-erythromycin gel combined with narrow-band ultraviolet B radiation is safe and effective,which is worthy of clinical popularization.