皮肤镜鉴别诊断外阴病毒疣与Bowen样丘疹病的价值

Dermoscopy in the differential diagnosis of vulvar condyloma acuminatum and Bowenoid papulosis

目的观察外阴病毒疣(condyloma acuminatum,CA)与Bowen样丘疹病(Bowenoid papulosis,BP)的皮肤镜下表现,探讨皮肤镜在二者鉴别诊断中的应用价值。方法外阴CA、BP患者各30例,均行皮肤镜检查,记录皮肤镜图像特征;以组织病理为金标准,计算皮肤镜诊断CA、BP的准确率、灵敏度及特异度。结果CA组粉红色和多形性血管皮损检出率(43.33%、83.33%)均高于BP组(6.67%、20.00%)(P<0.05),灰褐色背景、球状血管及线状分布棕褐色点检出率(16.67%、10.00%、0)低于BP组(56.67%、70.00%、60.00%)(P<0.05)。皮肤镜诊断CA的灵敏度、特异度及准确率分别为93.33%、90.00%、91.67%;诊断BP的灵敏度、特异度及准确率分别为80.00%、86.67%、83.33%。结论观察皮肤镜下皮损形态、背景颜色、血管及色素点分布形式,有助于外阴CA与BP的鉴别诊断。

Objective To observe the dermoscopic findings of vulvar condyloma acuminatum(CA)and Bowenoid papulosis(BP)and to investigate the application of dermoscopy in the differential diagnosis between vulvar CA and BP.Methods Thirty patients with CA and 30patients with BP underwent dermoscopy and were recorded the imaging features of dermoscopy.Taking histopathological results as gold standard,the accuracy,sensitivity and specificity of CA and BP by dermoscopy were calculated.Results The detection rates of pink and polymorphic blood vessels lesion were higher in CA group(43.33%,83.33%)than those in BP group(6.67%,20.00%)(P<0.05).The detection rates of gray-brown background,spheroidal blood vessels and linear distribution of pigment spots were lower in CA group(16.67%,10.00%,0)than those in BP group(56.67%,70.00%,60.00%)(P<0.05).The sensitivity,specificity and accuracy of dermoscopic diagnosis of CA were 93.33%,90.00%and 91.67%,respectively.The sensitivity,specificity and accuracy of dermoscopic diagnosis of BP were 80.00%,86.67%and 83.33%,respectively.Conclusion To observe the lesion morphology,background color,the distribution of vessels and pigment spots under dermoscopy contributes to the differential diagnosis of CA and BP.