斑秃患者的临床特征-附524例临床、皮肤镜及病理特点

A retrospective analysis of clinical, dermoscopic and histopatfaological features of 524 patients with alopecia areata

目的:总结斑秃患者临床和实验室特点、皮肤镜征象及病理特点。方法:回顾性分析524例斑秃的临床资料及部分患者血清学检查、皮肤镜特点、病理检查并比较其相关关系。结果:脱发面积与患者的年龄、发病年龄呈明显负相关,与甲改变发生率呈正相关,即脱发面积大的重型患者,其发病年龄较小且伴有甲改变。全、普秃患者血清IgE浓度高于斑片型和弥漫型患者。拉发试验阳性率与皮肤镜下断发、黑点、感叹号发的发生率呈正相关。34.6%的患者皮损中可见毛囊周围或血管周围嗜酸粒细胞浸润,弥漫型斑秃患者嗜酸粒细胞浸润发生率高于斑片型和全、普秃患者。结论:通过皮肤镜征象和病理表现可以进一步了解患者皮损的发展阶段以及监测疾病活动性。

Objective： To analyze clinical, dermoseopic, and histopathological features of patients with alopecia areata （AA）. Methods： Clinical and laboratory data including dermoscopic and pathological findings of 524 newly diagnosed AA patients were analyzed retrospectively. Results： Hairloss area was negatively correlated with the age and onset age of AA patients, but positively correlated with nail involvement. Serum IgE level in alopecia totalis （AT） and alopecia universalis （AU） was higher than that in diffuse alopecia areata （DAA） and patchy AA （PAA）. Broken hairs, black dots and exclamation mark hairs were found to be positively correlated with positive hairpull test. Perifollicular and perivascular eosinophil infiltration was found in 34.6% of AA patients. Eosinophil infiltration was higher in DAA patients than in AT, AU and PAA patients. Conclusion： Dermoscopic and pathological findings may survey the activity and stage of AA patients.