甲下出血34例皮肤镜特征分析

Dermoscopic Features Analysis of 34 Cases with Subungual Hematoma

目的 分析甲下出血皮肤镜下特征,探讨皮肤镜在甲色素性疾病鉴别诊断中的应用价值。方法 收集2017年10月-2019年9月在暨南大学附属第一医院皮肤科门诊就诊并行皮肤镜检查的甲下出血患者60例,选取其中有明确外伤史的34例稳定期甲下出血患者并将其分为挤压伤组及砸伤组,统计34例患者共计45处皮损的皮肤镜检查结果,分析其特征。结果 34例患者,男10例,女24例,其中挤压伤稳定期甲下出血25例,观察皮损36处,砸伤导致的稳定期甲下出血9例,观察皮损9处。45处皮损可见均质的红黑色或棕黑色色素沉着斑,30处皮损沿色素斑两端或侧缘有圆形红色、红黑色小球,22处皮损甲两端伴有条纹,31处色素斑周围颜色变淡。挤压伤和砸伤所致甲下出血皮肤镜下表现无明显差异。结论 甲下出血的皮肤镜表现具有一定的特征性,临床上可辅助诊断甲下出血,挤压伤和砸伤所致甲下出血在皮肤镜下表现无差异性特征。

Objective To analyse dermoscopic features of subungual hematoma,and to explore the application of dermoscopy in differential diagnosis of nail pigmentations.Methods Sixty patients with subungual hematoma were collected from department of dermatology of The First Affiliated Hospital of Jinan University.Thirty-four patients with stable subungual hematoma with a history of trauma were selected and divided into crush injury group and smash injury group.Fourty-five lesions were detected by dermoscopy and analysed.Results Thirty-four patients include 10 males and 24 females,25 crush injuries and 9 smash injuries.Homogenous reddish to reddish-black pigmentation were observed in all the lesions,multiple reddish globules at the lateral and/or both the distal and proximal edge of the pigmented area were observed in 30 lesions,streaklike pigment at distal portion of pigmented area was observed in 22 lesions,the color around the pigmentation spots fades in 31 lesions.There was no difference in the characteristics of subungual hematoma caused by crush injuries and smash injuries.Conclusion The subungual hematoma have certain characteristics under dermoscopy, so the features can assist the diagnosis.There is no difference in the characteristics of subungual hematoma caused by crush injuries and smash injuries.