皮肤镜在面部激素依赖性皮炎和脂溢性皮炎诊断中的应用评价

The Appliciation of Dermoscopic Diagnosis in Facial Corticosteroid Addictive Dermatitis and Seborrheic Dermatitis

目的总结面部激素依赖性皮炎和脂溢性皮炎的皮肤镜特征,评估皮肤镜在二者鉴别诊断中的意义。方法选择2015年9月-2016年1月本院收治的面部激素依赖性皮炎(FCAD,47例)和脂溢性皮炎(SD,39例),分析该两组疾病皮肤镜下特点(背景颜色、血管形态、血管排列方式、毛囊异常、鳞屑表现及其他相关指征)。结果该两组疾病患者均见玫瑰花团结构。FCAD患者皮肤镜下见红色或深红色背景下的多形性或分支状血管呈网状或不规则性分布,点状或线状血管比例较低。SD患者为黄红色或红色背景下的多形性或点状血管呈不规则性或簇状排列,多见黄色鳞屑,部分可见毛囊周围黄红色油滴状晕样结构,毛囊角栓。结论 FCAD患者和SD患者皮肤镜下特征截然不同,皮肤镜检查有助于诊断和鉴别诊断该两组疾病。

Objective To summarize the dermoscopic features of facial corticosteroid addictive dermatitis （FCAD）and seborrheic dermatitis（ SD）, evaluate the significance in differential diagnosis between them. Methods Collected 47 FCAD patients and 39 SD patients who treated in the dermatology clinic of the Affiliated Hospital of Tianjin traditional Chinese Medicine Affiliated Hospital in September 2015 to January 2016, analyzed dermoscopic features of them（e, g. background color, vascular morphology, vascular arrangement analysis, abnormal follicle, scales and aother related indications）. Results Both of them were seen＂ rosettes＂ structure, FCAD showed mainly that in red or deep red background, the ploymorphic or arborzing vessels distributed reticularly or irregularly, and the dotted or linear vessels were lower than others. SD proformed that in yellowish-red or red background, pleomorphic or dotted vessels showed irregularor clustered arrangement, and most of them could be seen yellow scales, part of them could beseen yellowish-red perifollicular whitish halo structures and perifollicular keratotic plugs. Conclusions FCAD and SD have totally different dermoscopic features, and it is helpful to the diagnosis and differential diagnosis of the two diseases.