Vázquez-López Francisco, Manjón-Haces José Antonio, Maldonado-Seral Cayetana, Raya-Aguado Cristina, Pérez-Oliva Narciso, Marghoob Ashfaq A
Department of Dermatology, Central University Hospital, University of Oviedo, Oviedo, Spain.
Dermatology. 2003;207(2):151-6. doi: 10.1159/000071785.
Dermoscopic features of common inflammatory dermatoses are not well studied and previous reports on this topic are limited to the search of vascular features (capillaroscopy).
Dermoscopic features of psoriasis and lichen planus (LP) are investigated to determine both vascular and nonvascular features of these two dermatoses.
Dermoscopic images of 25 patients with LP and 20 patients with plaque psoriasis (PP) were evaluated. Findings were statistically analyzed including the reproducibility of scoring (Cohen's kappa statistics).
Our observations clearly showed that the evaluation of both vascular and nonvascular findings improved the surface microscopy of these diseases. A vascular feature (homogeneous red globules) was the most significant dermoscopic finding in the PP dermoscopic pattern (20/20, 100%; p < 0.001). A nonvascular feature (whitish striae) was the most significant dermoscopic feature in the LP pattern (23/25, 92%; p < 0.001). Dermoscopic features of LP also included gray-blue dots, comedo, milium-like cysts, and vascular structures (red lines). The intraobserver and interobserver reproducibility of scoring was very high (k value, 0.9).
Our study shows for the first time that the efficacy of surface microscopy of common inflammatory dermatoses may be improved by investigating both vascular and nonvascular findings and its practicability in daily practice by using the dermoscope. Although dermoscopy does not provide clear additional help in the clinical differentiation between typical PP and LP, it could be helpful in patients with darker skin and for teaching settings.
常见炎症性皮肤病的皮肤镜特征尚未得到充分研究，此前关于该主题的报告仅限于血管特征（毛细血管镜检查）的研究。
研究银屑病和扁平苔藓（LP）的皮肤镜特征，以确定这两种皮肤病的血管和非血管特征。
对25例LP患者和20例斑块状银屑病（PP）患者的皮肤镜图像进行评估。对结果进行统计学分析，包括评分的可重复性（Cohen卡方统计）。
我们的观察结果清楚地表明，对血管和非血管表现的评估改善了这些疾病的体表显微镜检查。血管特征（均匀的红色小球）是PP皮肤镜模式中最显著的皮肤镜表现（20/20，100%；p<0.001）。非血管特征（白色条纹）是LP模式中最显著的皮肤镜特征（23/25，92%；p<0.001）。LP的皮肤镜特征还包括灰蓝色点、粉刺、粟丘疹样囊肿和血管结构（红线）。观察者内和观察者间评分的可重复性非常高（k值，0.9）。
我们的研究首次表明，通过研究血管和非血管表现，可提高常见炎症性皮肤病体表显微镜检查的有效性，并且使用皮肤镜在日常实践中具有实用性。虽然皮肤镜在典型PP和LP的临床鉴别中没有提供明确的额外帮助，但它可能对皮肤较黑的患者和教学环境有帮助。
