15例甲下骨疣皮肤镜和组织病理表现的相关性

Correlation between dermatoscopy and histopathological features in 15 cases of subungual exostosis

目的:总结分析甲下骨疣在皮肤镜下的特征表现,为皮肤镜辅助诊断甲下骨疣进一步提供依据。方法:回顾性分析我院2016年—2020年通过组织病理检查确诊的甲下骨疣患者,对其皮肤镜表现进行分析总结。结果:15例甲下骨疣的患者中,1例并发甲沟炎;皮肤镜中出现黄色角化结构40%(6例)、白色角化60%(9例)、红白色均质结构100%(15例)、线状血管扩张67%(10例)、规则边缘93%(14例)、红褐色均质结构27%(4例)、甲周红斑7%(1例)。组织病理中均可见角化过度100%(15例)、纤维软骨帽100%(15例)、成熟骨组织100%(15例)、成熟软骨组织100%(15例)。结论:皮肤镜所见黄白角化和组织病理角化过度比例接近,红白色均质结构和纤维软骨帽比例一致,因此黄白色角化和病理角化过度有一定相关性;红白色均质和病理纤维软骨帽有一定相关性。

Objective:To summarize and analyze the characteristics of subungual exostosis under dermatoscopy,and to provide a basis for diagnosis of subungual exostosis under dermatoscopy.Methods:A retrospective analysis was performed in subungual exostosis cases diagnosed by histopathology in Xijing hospital from 2016 to 2020.The dermatoscopic manifestations were analyzed and summarized.Results:Among the 15 cases with subungual exostosis,1 case was complicated with paronychia.The results of dermoscopy showed that 6 patients(40%)with yellow keratosis,9 patients(60%)with white keratosis,15 patients(100%)with red-white homogeneous structure,10 patients(67%)with linear vascular dilatation,14 patients(93%)with regular margin,4 patients(27%)with red-brown homogeneous structure,and 1 patient(7%)with periungual erythema.Histopathological examination showed hyperkeratosis,fibrous cartilage cap,and mature trabecular bone in all cases.Conclusion:The proportion of yellow and white keratosis seen by dermoscopy was close to that of histopathological hyperkeratosis,and the proportion of red-white homogeneous structure was consistent with that of fibrous cartilage cap.There was a certain correlation between yellow-white keratosis and histopathological hyperkeratosis.The red-white homogeneous structure was correlated with fibrous cartilage cap.