粟丘疹样汗管瘤37例临床及皮肤镜特征分析

Clinical and dermoscopy features analysis of 37 cases with milium-like syringoma

目的探讨皮肤镜在粟丘疹样汗管瘤诊断及鉴别诊断中的意义。方法回顾分析我院门诊就诊的37例粟丘疹样汗管瘤患者临床、组织病理资料及皮肤镜特征,并比较粟丘疹样汗管瘤与汗管瘤、粟丘疹皮肤镜特征的差异。结果粟丘疹样汗管瘤37例患者(男9例,女28例),平均发病年龄(40.12±9.10)岁。典型皮损表现为直径0.5~5 mm群集性丘疹,大部分丘疹顶端见粟丘疹样损害。经组织病理确诊,粟丘疹样汗管瘤、汗管瘤、粟丘疹在皮肤镜下有其各自特点。粟丘疹样汗管瘤在皮肤镜下皮损区主要表现为典型的花环样结构,细小的色素网状结构。汗管瘤主要表现为单个或簇集性黄白色均质性结构,周围围绕纤细的浅褐色色素网。粟丘疹表现为亮白色均质结构。结论粟丘疹样汗管瘤是汗管瘤的一种亚型,皮肤镜有助于汗管瘤、粟丘疹及粟丘疹样汗管瘤的鉴别诊断。

Objective To explore the value of dermoscopy in the diagnosis and differential diagnosis of milium-like syringoma. Methods The clinical, dermoscopic and pathological data of 37 cases with milium-like syringoma was retrospectively analyzed, and the dermoscopic features were compared between milium-like syringoma, syringoma and milium. Results There were 9 males and 28 females, and the average age of onset was 40.12±9.10 years old. Typical lesions manifested as scattered or clustered papules with a diameter of 0.5-5 mm in size, and the milium-like lesions were usually on the top of the papules. Histopathologically proven milium-like syringoma, syringoma and milium had their own characteristics under dermoscopy. Milium-like syringoma mainly showed the fine pigment network and a rosette structure. Syringoma mainly showed yellow-whitish structures, light brown pigment network at the periphery. Milium mainly demonstrated features of glittering whitish structures. Conclusion Milium-like syringoma is a variant of syringoma. Dermoscopy may be a valuable tool in the differential diagnosis of milium-like syringoma and milium.