白色线状苔藓58例临床及皮肤CT特点分析

The Clinical and RCM Features of 58 Lichen Striatus Albus Cases

目的分析白色线状苔藓(lichen striatus albus,LSA)的临床及皮肤CT特点。方法回顾性分析LSA患者的皮肤CT、组织病理及临床资料。结果 58例患者中,男26例,女32例,年龄1~33岁,平均6.97±5.36岁。皮损位于下肢25例,上肢15例,面颈部8例,躯干7例,手背3例。临床上LSA表现为单侧沿Blaschko线分布的色素减退斑。皮肤CT下LSA表现为轻度角化过度,表皮水肿,基底层黑色素减少,局部基底层液化。真皮乳头及浅层可见少至中等量单个核细胞,散在分布少量形态不规则的高反光大细胞,为噬黑素细胞。结论儿童四肢突然出现的单侧沿Blaschko线分布的色素减退斑,结合皮肤CT显示的局部基底细胞液化,炎症背景下可见形态不规则的高反光大细胞,高度提示LSA的诊断。

Objective To evaluate the clinical and RCM（reflectance confocal microscopy）characteristics of lichen striatus albus（LSA）. Methods A retrospective analysis of clinical, RCM and histopathological features based on 58 lichen striatus albus cases. Results The mean age of the 58 cases（26 male and 32 female）was 6.97 years（ranging from 1 to 33 years）.Twenty-five patients had lesions on the lower limbs,15 on the upper limbs,8 on face or neck,7 on the trunk,and 3 on hands.Clinically,lichen striatus albus presented with linear distribution of hypopigmentation following Blaschko＇s lines.Under RCM, LSA showed mild hyperkeratosis, epidermis edema, basal layer reflection reduced, focal interface dermatitis at the dermal-epidermal junction, infiltration of lymphocytes,including some big bright cells in the dermal papilla.Conclusion Linear distribution of hypopigmentation with RCM showed focal interface dermatitis or lichenoid patterns at the dermal-epidermal junction could highly suggest LSA.