Llambrich A, Zaballos P, Terrasa F, Torne I, Puig S, Malvehy J
Department of Dermatology, Hospital Son Llàtzer, Palma de Mallorca, Spain.
Br J Dermatol. 2009 Apr;160(4):756-61. doi: 10.1111/j.1365-2133.2008.08986.x. Epub 2008 Dec 16.
Dermoscopy has been proposed as a diagnostic tool in the case of skin infections and parasitosis but no specific dermoscopic criteria have been described for cutaneous leishmaniasis (CL).
To describe the dermoscopic features of CL.
Dermoscopic examination (using the DermLite Foto; 3Gen, LLC, Dana Point, CA, U.S.A.) of 26 CL lesions was performed to evaluate specific dermoscopic criteria.
We observed the following dermoscopic features: generalized erythema (100%), 'yellow tears' (53%), hyperkeratosis (50%), central erosion/ulceration (46%), erosion/ulceration associated with hyperkeratosis (38%) and 'white starburst-like pattern' (38%). Interestingly, at least one vascular structure described in skin neoplasms was observed in all cases: comma-shaped vessels (73%), linear irregular vessels (57%), dotted vessels (53%), polymorphous/atypical vessels (26%), hairpin vessels (19%), arborizing telangiectasia (11%), corkscrew vessels (7%) and glomerular-like vessels (7%). Combination of two or more different types of vascular structures was present in 23 of 26 CL lesions (88%), with a combination of two vascular structures in 13 cases (50%) and three or more in 10 cases (38%).
Characteristic dermoscopic structures have been identified in CL. Important vascular patterns seen in melanocytic and nonmelanocytic tumours are frequently observed in this infection.
皮肤镜已被提议作为皮肤感染和寄生虫病的诊断工具,但对于皮肤利什曼病(CL)尚未描述具体的皮肤镜标准。
描述CL的皮肤镜特征。
对26例CL皮损进行皮肤镜检查(使用美国加利福尼亚州达纳角3Gen有限责任公司的DermLite Foto),以评估具体的皮肤镜标准。
我们观察到以下皮肤镜特征:全身性红斑(100%)、“黄色泪滴”(53%)、角化过度(50%)、中央糜烂/溃疡(46%)、与角化过度相关的糜烂/溃疡(38%)和“白色星爆样图案”(38%)。有趣的是,在所有病例中均观察到至少一种在皮肤肿瘤中描述过的血管结构:逗号状血管(73%)、线性不规则血管(57%)、点状血管(53%)、多形性/非典型血管(26%)、发夹状血管(19%)、树枝状毛细血管扩张(11%)、螺旋状血管(7%)和肾小球样血管(7%)。26例CL皮损中有23例(88%)存在两种或更多不同类型血管结构的组合,其中13例(50%)为两种血管结构的组合,10例(38%)为三种或更多血管结构的组合。
已在CL中识别出特征性的皮肤镜结构。在这种感染中经常观察到黑素细胞性和非黑素细胞性肿瘤中所见的重要血管模式。