寻常性银屑病、慢性湿疹和玫瑰糠疹187例皮肤镜特征分析

Psoriasis vulgaris, chronic eczema and pityriasis rosea: 187 cases of dermoscopic analysis

目的 :探讨寻常性银屑病、慢性湿疹、玫瑰糠疹在皮肤镜下的皮损特征。方法 :选取117例寻常性银屑病、50例慢性湿疹和20例玫瑰糠疹患者,使用皮肤镜观察其皮损的背景颜色、鳞屑颜色、鳞屑分布、血管形态、血管排列模式和血管走行方向。结果:皮肤镜下主要特征:寻常性银屑病为低倍下红色背景、白色鳞屑、规则排列模式、点状血管和高倍下肾小球状血管,其特异度依次为29%、44%、26%、77%、96%、97%,红色背景、点状血管、规则排列同时存在时灵敏度为98%,特异度为97%。慢性湿疹为红色背景、黄色鳞屑、不规则排列模式、点状血管和高倍下多种血管形态。玫瑰糠疹为黄色背景,外周内缘游离鳞屑。结论:皮肤镜下寻常性银屑病、慢性湿疹及玫瑰糠疹的不同模式,可用于临床辅助诊断。

Objective： To explore the characteristics of the skin lesion of psoriasis vulgaris, chronic eczema and pityriasis rosea examined by dermoscope. Method： Dermoscope was used to observe the background color, the color and distribution of scales, the morphology, arrangement and direction of blood vessels of the skin lesions in 117 patients with psoriasis vulgaris, 50 cases of chronic eczema and 20 cases of pityriasis rosea. Results： The main dermoscopic features of the skin lesion of psoriasis vulgaris were red background, white scales, regular blood vessel arrangement, dotted vessels, and glomeruloid vessels under high magnification. The specificity of these features for psoriasis vulgaris were 29%, 44%, 26%, 77%, 96% and 97%, respectively. When red background, dotted vessels and regular blood vessel arrangement appeared together, the sensitivity and the specificity for psoriasis vulgaris were 98% and 97%, respectively. The main features of the skin lesion of chronic eczema were red background, yellowish scales, dotted blood vessels and irregular blood vessel arrangement. The main features of the skin lesion of pityriasis rosea were yellow background and typical scales. The morphology of the scales was such that the fine fragments of scales were attached only at the periphery of the skin. Conclusion： The different dermoscopie patterns of the skin lesion of psoriasis vulgaris, chronic eczema and pityriasis rosea may be helpful to the clinical diagnosis.