儿童晕痣的皮肤镜表现及临床特征

Dermoscopic and clinical features of halo nevus in children

目的 总结儿童晕痣患者的皮肤镜表现及临床特征。方法 回顾性分析2019年1月—2023年2月于我院诊治的110例晕痣患者的一般情况、病程、临床特点、家族史等临床资料及皮肤镜图像。结果 儿童晕痣平均发病年龄(8.91±3.26)岁,男女比例约为1.29∶1,发生于面颈部者占32.82%。有40.00%患者合并白癜风,白癜风患者中多发晕痣者比例高于无白癜风患者,差异有统计学意义(χ^(2)=8.61,P=0.003)。共45例患者提供家族史,合并白癜风患者中的有家族史者所占比例(31.82%,7/22)高于无白癜风患者(4.35%,1/23),差异有统计学意义(χ^(2)=4.08,P=0.043)。中心痣最常见的模式为均质模式21个(36.84%),球状模式10个(17.54%);痣周白斑最常见的为无结构色素减退36个(63.16%)。口服复方甘草酸苷片+外用糖皮质激素/钙调磷酸酶抑制剂治疗,6个月后有效率为70.00%;复色患者中的未合并自身免疫系统疾病者所占比例(78.57%,22/28)低于未复色患者(33.33%,4/12),差异有统计学意义(χ^(2)=5.70,P=0.017)。结论 晕痣无性别差异,好发于面颈部,并发白癜风概率高,皮肤镜下中心痣以均质或者小球模式为主,痣周白斑多呈现无结构色素减退斑。口服药物联合外用药物治疗对于儿童晕痣具有一定疗效。

Objective To study the dermoscopic and clinical features of halo nevus in children.Methods We retrospectively analyzed the clinical data,including general condition,clinical features,family history and dermoscopic data of 110 patients with halo nevus in our hospital from January 2019 to February 2023.Results The mean age of 110 patients was(8.91±3.26)years.The ratio of male to female was 1.29∶1.Involvements on the face and neck accounted for 32.82%,and 40.00%of patients were complicated with vitiligo.The incidence of multiple halo nevi was higher in patients with vitiligo than in those without vitiligo(χ^(2)=8.61,P=0.003).Among the 45 cases with a family history,the proportion of individuals with family history was higher in patients with vitiligo(7/22,31.82%)than in those without vitiligo(1/23,4.35%)(χ^(2)=4.08,P=0.043).The most common dermoscopic features of central nevi were homogeneous pattern(21 cases,36.84%)and globular pattern(10 cases,17.54%).The peripheral halo often presented as structureless hypopigmentation(36 cases,63.16%).Improvement was observed in 70.00%of the patients after 6-month treatment with oral compound glycyrrhizin tablets plus topical glucocorticoids/0.03%tacrolimus ointment.The proportion of patients without autoimmune diseases was lower in effective cases than in the ineffective cases(χ^(2)=5.70,P<0.05).Conclusions Halo nevus mainly occurs on the face and neck,with no gender difference.The incidence of vitiligo is higher in patients with halon nevus.The most common dermoscopic pattern of the central nevus is homogeneous or globular pattern,and the peripheral halo commonly shows structureless hypopigmentation rim.Oral drugs combined with topical drugs are effective in the treatment of halo nevus in children.