50例儿童头癣皮肤镜特征分析

Dermoscopic Features of Tinea Capitis in 50 Cases of Children

目的 探讨儿童头癣皮肤镜特征性在临床诊疗中的价值。方法 选取2019年1月—2020年12月本院门诊诊治的50例头癣患儿采用回顾性分析,分析比较皮肤镜特征性表现以及不同临床分型之间皮肤镜表现的差异,并观察治疗期间皮肤镜表现的变化情况。结果 唐山地区儿童头癣最常见的临床分型是白癣(64%),儿童头癣的特征性皮肤镜表现包括摩斯码样发(64%)、Z型发(36%)、螺旋样发(30%)和逗号样发(18%),在有以上表现的病发进行取材,真菌镜检阳性率较高。逗号样发是黑点癣的特征性表现。随着治疗时间延长,治疗对真菌镜检结果的影响早于皮肤镜表现的影响,皮肤镜表现的消失与临床痊愈高度一致。结论 皮肤镜特征性表现对儿童头癣的临床分型有一定的提示性作用,可用于儿童头癣的辅助诊断及治疗期间的动态观察。

Objective In order to investigate the value of dermoscopy during the diagnosis and treatment of tinea capitis in children.Methods Fifty children with tinea capitis diagnosed and treated in our hospital from January 2019 to December 2020 were retrospectively analyzed.The characteristic features of dermoscopy and the differences of dermoscopy findings between different clinical types were analyzed and compared,and the changes of dermoscopy findings during treatment were observed.Results The most common clinical classification of tinea capitis in children in Tangshan area was tinea alba(64%).The characteristic dermoscopic findings of tinea capitis in children included moss code hair(64%),Z hair(36%),spiral hair(30%)and comma hair(18%).Comma-like hair was a characteristic feature of tinea nigricans.With the prolongation of treatment time,the effect of treatment on fungal microscopic findings was earlier than the effect of dermoscopic findings,and the disappearance of dermoscopic findings was highly consistent with clinical recovery.Conclusion The characteristic features of dermoscopy have certain suggestive effect on the clinical classification of tinea capitis in children,and can be used for the auxiliary diagnosis of tinea capitis in children and dynamic observation during treatment.