持久性色素异常性红斑5例皮肤镜和反射式共聚焦显微镜特征分析

Dermoscopic and reflectance confocal microscopic characteristics of five cases of erythema dyschromicum perstans

目的分析持久性色素异常性红斑(EDP)的皮肤镜和反射式共聚焦显微镜(RCM)特征, 探讨皮肤镜和RCM对EDP的辅助诊断价值。方法回顾性收集2020年1 - 12月在杭州市第三人民医院皮肤科门诊就诊的5例EDP患者资料。每例选择3处典型皮损, 分析这15处皮损的皮肤镜及RCM检查结果, 其中2例在观察部位取材行常规组织病理检查。结果 5例EDP患者年龄24 ~ 62岁, 平均40.8岁;男3例, 女2例;病程3 ~ 48个月, 平均15.7个月。3例皮损呈灰青色斑片并泛发于躯干, 1例皮损位于双上肢, 1例颈部皮损单发。皮肤镜检查显示, 15处皮损均表现为黑胡椒粉样结构。RCM检查显示, 15处皮损均可见局灶性基底细胞液化变性。2例皮损组织病理学检查示, 基底细胞灶状液化变性, 真皮乳头散在噬色素细胞。结论 EDP在皮肤镜及RCM下有典型特征, 可为其诊断及鉴别诊断提供依据。

Objective To analyze the dermoscopic and reflectance confocal microscopic characteristics of erythema dyschromicum perstans(EDP),and to explore the value of dermoscopy and reflectance confocal microscopy(RCM)in the auxiliary diagnosis of EDP.Methods Clinical data were retrospectively collected from 5 patients with EDP,who visited and were treated in the Department of Dermatology,Hangzhou Third People's Hospital from January to December 2020.Three typical lesions were chosen from each patient,and the 15 lesions were examined by dermoscopy and RCM.Skin specimens were taken from 2 cases at the observation sites for histopathological examination.Results Among the 5 EDP patients,there were 3 males and 2 females,with an average age of 40.8 years(range,24-62 years)and an average disease course of 15.7 months(range,3-48 months).Greyish-green patches extended to the trunk were observed in 3 cases,1 case presented with lesions located on the bilateral upper limbs,and 1 presented with a solitary lesion on the neck.Dermoscopy showed that all 15 lesions exhibited a black pepper-like structure.RCM revealed focal liquefaction degeneration of basal cells in all 15 lesions.Histopathological examination of 2 cases showed focal liquefaction degeneration of basal cells and scattered pigmentophages in the dermal papilla.Conclusion EDP has typical dermoscopic and RCM characteristics,which could provide a basis for its diagnosis and differential diagnosis.