51例日光性角化病皮肤镜下的特点的研究

Study on the characteristics of 51 cases of actinic keratosis of the skin under the microscope

目的 :总结国人日光性角化病在皮肤镜下的特点,为临床皮肤镜鉴别色素性皮损提供指导。方法 :回顾性分析在复旦大学附属华山医院皮肤科皮肤镜诊断及病理确认为日光性角化病的病人的皮肤镜图像。结果 :在表现有非色素性皮损的17例日光性角化病患者中17例(100%)表现为"草莓样表面"模式,红斑背景下的伪网格状结构为74.5%,周边有白圈的白色毛囊为43.1%,靶形毛囊,草莓样的表面;红斑在非色素性日光性角化病中常见(82.4%)。在色素性例日光性角化病患者中,表现为毛囊口周围点状或球状结构为52.6%,"环形颗粒状"结构为31.5%,表现有褐色或黑色伪网格结构为36.8%。结论 :皮肤镜可在结合临床病史基础上提高诊断日光性角化病的准确率。

Obective To summarize the dermoscopic features of actinic keratosis(AK)in Chinese in order to provide the ba-sis for differerntial diagnosis of pigmented lesions with dermoscopy.Methods All the dermoscopic images of AKs lesions from the database in the Department of Dermatology Huashan Hospital,from 2013.6 to 2013.12,were analyzed .The diagnosis were patho-logically confirmed.Results In Our study we observed,all of non-pigmented Aks(17 lesions),repetitive dermoscopic features of‘ strawberry’pattern.Background of erythema that surrounded follicles with whitish halos is 74.5%.Structureless red areas which, intermingled with evident,targetoid inner yellowand outer white round structures is43.1%,a whitish-yellowish‘targetoid’ appear-ance is 64.7%;Erythema is 90%.Dermoscopic characteristics of pigmented AKs include multiple slategray to dark-brown dots and globules around the follicular ostia is 52.6%,the annular-granular pattern is 31.5%,the brown to gray pseudonetwor is 36.8%. Conclusion The specificity of the diagnosis by used dermoscopy was higher than that of the inexperienced clinician.