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韩国患者的进行性黄斑色素减退症:一项临床病理研究。

Progressive macular hypomelanosis in korean patients: a clinicopathologic study.

作者信息

Hwang Seon Wook, Hong Soon Kwon, Kim Sang Hyun, Park Jeong Hoon, Seo Jong Keun, Sung Ho Suk, Lee Deborah

机构信息

Department of Dermatology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

出版信息

Ann Dermatol. 2009 Aug;21(3):261-7. doi: 10.5021/ad.2009.21.3.261. Epub 2009 Aug 31.

Abstract

BACKGROUND

Progressive macular hypomelanosis is characterized by ill-defined, non-scaly, hypopigmented macules primarily on the trunk of the body. Although numerous cases of progressive macular hypomelanosis have been reported, there have been no clinicopathologic studies of progressive macular hypomelanosis in Korean patients.

OBJECTIVE

In this study we examined the clinical characteristics, histologic findings, and treatment methods for progressive macular hypomelanosis in a Korean population.

METHODS

Between 1996 and 2005, 20 patients presented to the Department of Dermatology at Busan Paik Hospital with acquired, non-scaly, confluent, hypopigmented macules on the trunk, and with no history of inflammation or infection. The medical records, clinical photographs, and pathologic findings for each patient were examined.

RESULTS

The patients included 5 men and 15 women. The mean age of onset was 21.05+/-3.47 years. The back was the most common site of involvement. All KOH examinations were negative. A Wood's lamp examination showed hypopigmented lesions compared with the adjacent normal skin. A microscopic examination showed a reduction in the number of melanin granules in the lesions compared with the adjacent normal skin, although S-100 immunohistochemical staining did not reveal significant differences in the number of melanocytes. Among the 20 patients, 7 received topical drug therapy, 6 were treated with narrow-band ultraviolet B phototherapy, 4 received oral minocycline, and 3 did not receive any treatment.

CONCLUSION

Most of the patients with progressive macular hypomelanosis had asymptomatic ill-defined, non-scaly, and symmetric hypopigmented macules, especially on the back and abdomen. Histologically, the number of melanocytes did not differ significantly between the hypopigmented macules and the normal perilesional skin. No effective treatment is known for progressive macular hypomelanosis; however, narrow-band ultraviolet B phototherapy may be a useful treatment modality.

摘要

背景

进行性斑状色素减退症的特征为边界不清、无鳞屑的色素减退斑,主要分布于躯干。尽管已有大量关于进行性斑状色素减退症的病例报道,但韩国患者的该病症临床病理研究尚未见报道。

目的

本研究旨在探讨韩国人群中进行性斑状色素减退症的临床特征、组织学表现及治疗方法。

方法

1996年至2005年间,20例患者因躯干出现后天性、无鳞屑、融合性色素减退斑且无炎症或感染史就诊于釜山白医院皮肤科。对每位患者的病历、临床照片及病理结果进行分析。

结果

患者包括5名男性和15名女性。平均发病年龄为21.05±3.47岁。背部是最常受累部位。所有氢氧化钾检查均为阴性。伍德灯检查显示病变部位色素减退。显微镜检查显示,与相邻正常皮肤相比,病变部位黑色素颗粒数量减少,尽管S-100免疫组化染色未显示黑素细胞数量有显著差异。20例患者中,7例接受局部药物治疗,6例接受窄谱中波紫外线光疗,4例口服米诺环素,3例未接受任何治疗。

结论

大多数进行性斑状色素减退症患者有无症状的边界不清、无鳞屑且对称的色素减退斑,尤其是背部和腹部。组织学上,色素减退斑与周围正常皮肤的黑素细胞数量无显著差异。目前尚无已知的有效治疗进行性斑状色素减退症的方法;然而,窄谱中波紫外线光疗可能是一种有效的治疗方式。

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