外阴硬化性苔藓的皮肤镜特征分析

Dermoscopic features of vulvar lichen sclerosus

目的 探讨外阴硬化性苔藓的皮肤镜特征。方法 回顾性分析2015年8月至2017年6月在北京协和医院皮肤科门诊就诊并行皮肤镜及皮肤组织病理检查的17例外阴硬化性苔藓患者的75处皮损的皮肤镜特征。结果 外阴硬化性苔藓皮损75处常见的皮肤镜特征为黄白色无结构区67处占89.3%，紫红色小球、斑片58处占77.3%，褐色或蓝灰色色素结构37处占49%，亮白色条纹30处占40%，不规则分布的点状21处占28%、线状44处占58.7%、发夹样5处占6.7%、逗号样10处占13%及树枝状血管15处占20%。3处（4%）皮肤镜下可见到玫瑰花瓣征，3处（4%）粉刺样开口，1处（1%）角栓。结论 外阴硬化性苔藓在皮肤镜下具有黄白色无结构区、紫红色小球、斑片、色素结构、多种形态血管等特征性表现。

Objective To investigate the dermoscopic features of vulvar lichen sclerosus （VLS）. Methods Seventeen patients with VLS, who visited the Department of Dermatology of Peking Union Medical College Hospital between August 2015 and June 2017 and underwent dermoscopy and skin histopathological examination, were enrolled into this study. The dermoscopic images of 75 skin lesions were collected and analyzed retrospectively. Results The common dermoscopic features in these VLS lesions included yellowish-white structureless areas （89.3%, 67/75）, reddish-violet globules or patches （77.3%, 58/75）, brownish or bluish-gray pigment structures （49%, 37/75）, shiny white streaks （40%, 30/75）, dotted vessels with irregular arrangement （28%, 21/75）, linear vessels （58.7%, 44/75）, hairpin-like vessels（6.7%, 5/75）, comma-like vessels （13%, 10/75）and branching vessels （20%, 15/75）. Under dermoscopy, rosette sign could be observed in 3 （4%） lesions, comedo-like openings in 3 （4%） lesions, and keratotic plugs in 1 （1%） lesions. Conclusion Under dermoscopy, VLS is characterized by yellowish-white structureless areas, reddish-violet globules or patches, pigment structures and vessels with various vessels.