178例掌跖部位黑素细胞性皮损的皮肤镜特点

Dermoscopic features of melanocytic lesions on volar skin： 178 case reports

目的探讨掌跖部位黑素细胞性皮损的皮肤镜特点。方法回顾性分析2009年9月至2011年10月在北京大学第一医院皮肤科行皮肤镜检查的掌跖部位黑素细胞性皮损的皮肤镜图像。结果共分析了121例患者的155个良I生黑素细胞性损害，22例患者的23个黑素瘤皮损。掌跖部位良性黑素细胞性皮损中最多见的皮肤镜模式为平行沟模式（占34．2％），其次为纤维样模式（占22．6％），有2个（1．3％）良性皮损表现为平行脊结构。23个黑素瘤皮损中12个（52．2％）出现平行脊结构，14个（60．9％）出现弥漫不规则的色素，且后者见于所有侵袭性黑素瘤中。纤维样结构作为肢端色素痣常见的一种良性皮肤镜模式，亦见于39．1％的黑素瘤中。结论皮肤镜在区分掌跖部位良性黑素细胞痣和黑素瘤方面有一定价值。

Objective To investigate the dermoscopic features of palmoplantar melanocytic lesions. Methods The dermoscopic images of palmoplantar melanocytic lesions that underwent examination in the Department of Dermatology in Peking University First Hospital from September 2009 to October 2011, were retrospectively analyzed. Results Totally, 155 benign acral melanocytic lesions in 121 patients and 23 acral melanomas in 22 patients were analysed in this study. Among the benign acral melanocytic lesions, the parallel furrow pattern and its variations （34.2%） were the most common, followed by the fibrillar pattern （22.6%）. Two benign lesions （1.3%） showed a parallel ridge pattern. Of 23 melanoma lesions, 12 （52.2%） exhibited parallel ridge pattern, and 14 （60.9%） showed irregular diffuse pigmentation that was present in all of the invasive melanoma lesions. The fibrillar pattern, as a common benign acral dermoscopic pattern, was also present in 39.1% of melanoma specimens. Conclusions Dermoscopy is valuable to some extent in the differential diagnosis of benign melanocytic nevi and malignant melanoma in palmoplantar region, and may facilitate the secreening for early melanoma.