皮肤镜在幼年黄色肉芽肿诊断中的应用

Application of dermoscopy in the diagnosis of juvenile xanthogranuloma

目的总结幼年黄色肉芽肿的皮肤镜图像特点,探讨皮肤镜检查在幼年黄色肉芽肿诊断中的意义。方法收集2019年1月-2021年1月皮肤科门诊31例经组织病理诊断为幼年黄色肉芽肿的患儿,回顾性分析其临床、皮肤镜及组织病理资料。结果31例患儿中有29例(93.5%)皮肤镜下可见“落日征”,20例(64.5%)可见黄色小球或黄色云状区域,12例(38.7%)可见线状血管,12例(38.7%)可见点球状血管,5例(16.1%)可见亮白色小球或条纹,2例(6.45%)可见色素网。病程<6个月患儿,皮肤镜主要表现为落日征及黄色云状区域,其次为线状或球状血管,组织病理表现多处于早期及成熟期:亮白色条纹及色素网主要见于病程>6个月患儿,组织病理表现多处于移行期。结论不同病程幼年黄色肉芽肿在皮肤镜下有其特征性表现,可以此作为儿童幼年黄色肉芽肿诊断及随访中的重要手段,减少有创的组织病理检查。

Objective To summarize the dermoscopic features of juvenile xanthogranuloma(JXG),and to evaluate the significance of dermoscopy in the diagnosis of JXG.MethodsA total of 31 children with JXG diagnosed by histopathological examination in the outpatient department of dermatology from January 2019 to January 2021 were collected for dermoscopy.The dermoscopic and histopathological datas ofthe children were retrospectively analyzed.ResultsAmong the 31 cases,29 cases showed"stting sun"sign(93.5%),20 cases showed yellow globules or clouds of paler yellow areas(64.5%),12 cases showed linear vessels(38.7%),12 cases showed dot globular vessels(38.7%),5 cases showed white globules or whitish streaks(16.1%),and 2 cases showed pigment network(6.45%)under the dermoscopy.In children with a course of disease lessthan 6 months,dermoscopic images mainly showed setting sun sign and clouds of paler yellow areas,followed by linear or globular vessels.The pathological mainly showed the early or mature stage manifestations.The whitish streaks an pigment network were mainly seen in children with a course of disease more than 6months,and the pathological mainly showed the transitional stage manifestations.Conclusion JXG of different disease stages has characteristic manifestations under dermoscopy,which can be used as an important means of diagnosis and follow-up,and can reduce the impact of invasive pathological examination on the physical and mental health of patients and their parents.