成人和儿童单发纵行黑甲皮肤镜表现回顾性对照研究

Retrospective Comparative Analysis of Dermoscopic Features of Longitudinal Melanonychia of Single Finger or Toe between Adults and Children

目的:比较成人和儿童单发纵行黑甲皮肤镜的表现,探索成人和儿童纵行黑甲的管理方法。方法:对2015年5月-2018年2月笔者科室诊治的86例儿童及成人单发LM患者的临床及皮肤镜下特点(出血点、棕色背景、不规则线条、规则线条、灰色背景伴灰色条带、micro-Hutchinson征、镜下可见微小凹槽、Hutchinson征、色素球及假性Hutchinson征)进行回顾性对照分析。结果:成人组63例,男女比43:20,平均年龄36.5岁。黑色条带宽度平均3.83mm,拇指受累最常见。皮肤镜下表现为出血点4例(6.35%),棕色背景41例(65.08%),不规则线条9例(14.29%),规则线条34例(53.97%),灰色背景伴灰色条带22例(34.92%),micro-Hutchinson征4例(6.35%),镜下可见微小凹槽2例(3.17%),假性Hutchinson征3例(4.76%),色素小球3例(4.76%),Hutchinson征9例(14.29%);儿童组23例,男女比14:9,平均年龄6.8岁。黑色条带宽度平均2.78mm,拇指受累最常见。出血点0例(0%),棕色背景19例(82.61%),不规则线条5例(21.74%),规则线条13例(56.52%),灰色背景伴灰色条带4例(17.39%),micro-Hutchinson征2例(8.70%),镜下可见微小凹槽0例(0%),假性Hutchinson征8例(34.78%),色素小球4例(17.39%),Hutchinson征10例(43.48%)。儿童组纵行黑甲Hutchinson征(P=0.004)和假性Hutchinson征(P<0.001)较成人常见,色素小球儿童组略多于成人组(P=0.058)。结论:Hutchinson征、假性Hutchinson征和色素小球在儿童中更为常见,证实皮肤镜在纵行黑甲筛查和随诊中的作用。

Objective Longitudinal melanonychia(LM)is a common symptom encountered in daily practice.The algorithm for typical dermoscopic patterns of LM are already well established.However,little is known about how the dermoscopic characteristics of LM differ between adults and children in the mainland of China.To compare the dermoscopic characteristics of LM between adults and children.Methods 63 cases of adults and 23 cases of children from May 2015 to February 2018 at our hospital were reviewed.Patients were evaluated by dermoscopy(Dermlite DL3N)and records of digital pictures were kept for analysis by categories as blood spots,brown coloration of background,irregular lines,regular lines,gray pigmented lines with grayish backgrounds,micro-Hutchinson sign,microscopic longitudinal grooves,Hutchinson sign,pigmented globules and pseudo-Hutchinson sign respectively.The results were compared by software between two groups.Results The dermoscopic findings of longitudinal melanonychia of single finger or toe from 23 children and 63 adults were analyzed.Hutchinson Sign(P=0.004),pseudo-Hutchinson sign(P<0.001)were detected more commonly in children,and pigmented globules(P=0.058)tended to be common in children too.No statistical evaluation of other categories between groups of adults and children had been found.Conclusion The dermoscopic findings showed the difference of the patterns of LM under dermoscopy between adults and children.