初诊为表皮囊肿的619例患者临床误诊分析

Analysis of clinical misdiagnosis in 619 patients initially diagnosed with epidermal cyst

目的:分析我院皮肤科门诊诊治表皮囊肿的临床误诊情况。方法:回顾性分析2020年1月—2023年1月于南京市鼓楼医院皮肤科就诊并初诊为表皮囊肿的619例患者临床和组织病理资料。结果:619例患者中男351例(56.7%),女268例(43.3%),平均年龄为(38.9±14.9)岁,年龄中位数为35岁。其中发生于头面部262例(42.3%),肩背部248例(40.1%),其他部位109例(17.6%)。组织病理证实误诊278例(44.9%),其中毛根鞘囊肿151例(24.4%),毛母质瘤35例(5.7%),皮内痣19例(3.1%),皮肤纤维瘤17例(2.7%),化脓性肉芽肿11例(1.8%),脂肪瘤、皮样囊肿、神经鞘瘤各5例(0.8%),其他30例(4.8%)。结论:表皮囊肿临床误诊率达44.9%,易误诊部位是头面部及上肢,最易被误诊疾病是毛根鞘囊肿。

Objective:To analyze the clinical misdiagnosis of epidermal cyst in the outpatient clinic.Methods:The clinical and pathological data of 619 patients who were initially diagnosed as epidermal cyst in the Department of Dermatology,Drum Tower Hospital,affiliated to Medical College of Nanjing University from January 2020 to January 2023 were collected and analyzed retrospectively.Results:A total of 619 patients were enrolled,of which 351 were males(56.7%),and 268 were females(43.3%).The average age of these patients was 38.8±14.9 years old,and the median age was 35 years old.Among them,262 patients(42.3%)had lesions in the head and face,248 patients(40.1%)had lesions in the shoulder and back,and109 patients(17.6%)had lesions in other parts of the body.A total of 278 cases were misdiagnosed as epidermal cyst based on the pathological examination,including 151(24.4%)trichilemmal cyst,35(5.7%)pilomatrixoma,19(3.1%)intradermal nevus,17(2.7%)cutaneous fibroma,11(1.8%)pyogenic granuloma,5(0.8%)lipoma,5(0.8%)dermoid cyst,5(0.8%)schwannoma,and30(4.8%)others.Conclusion:The rate of clinical misdiagnosis of epidermal cyst is 44.9%.The most common misdiagnosed areas are the head,face and upper limbs.The most common misdiagnosis is trichilemmal cyst.