晕痣的流行病学调查、临床特征及皮肤镜表现

The Epidemiology, Clinical and Dermoscopic Features of Halo Nevus

目的研究晕痣的流行病学、临床及皮肤镜特征。方法晕痣和/或白癜风患者填写相关调查问卷,对晕痣患者进行伍德灯和皮肤镜检查,随访3~6个月。结果 318例白癜风患者完成问卷,11.01%伴发晕痣。47例晕痣(91处晕痣)患者完成了调查问卷和临床体检,74.47%的晕痣患者伴发白癜风,25.53%伴发其他自身免疫病。晕痣好发于躯干,多为单发。晕痣中心痣在皮肤镜下以均质模式和小球模式为主,痣周白斑多呈无结构的色素减退斑。消退期晕痣的痣周白斑常可见血管结构,且在伍德灯下痣周白斑面积大于肉眼所见面积。手术切除、外用药联合系统糖皮质激素或光疗对晕痣治疗效果较好。结论晕痣约占白癜风的11.01%,其并发白癜风或其他自身免疫性疾病比例明显升高。晕痣在皮肤镜下具有特征性表现,伍德灯和皮肤镜是协助判断临床分期和预后的重要手段。

Objective To study epidemiology, clinical and dermoscopic features of halo nevus.Methods Patients diagnosed with halo nevus and/or vitiligo were asked to complete the questionnaires and received dermatological examinations.Patients with halo nevus were also examined by Wood′s lamp and dermoscopy and were followed up for three to six months.Results A total of 318 vitiligo patients completed the questionnaires;11.01% of them had halo nevi.Totally 47 halo nevus patients(91 halo nevi) completed the questionnaires and clinical examination.Among halo nevus patients, 74.47% had vitiligo and 25.53% other autoimmune diseases.Halo nevus moles were often located on the trunk, and most of them were single.The most common dermoscopic features of central nevi were homogeneous and glomerular patterns, and the peripheral nevi mostly showed unstructured hypopigmentation.Telangiectasia was usually observed when the halo nevus was in regression.Moreover, the depigmentation observed under Wood′s lamp was more extensive than under ordinary light, which allowed to predict the clinical stage of halo nevus.Surgical removal of halo nevi, topical medicine combined with systemic glucocorticoids or phototherapy, proved effective.Conclusion Halo nevus occurres in 11.01% of the vitiligo patients and is often complicated with vitiligo and other autoimmune diseases.Halo nevus has specific dermoscopic features.Wood′s light and dermoscopic examination play essential roles in determining the clinical stage and prognosis of halo nevus.