Department of Dermatology, School of Medicine, Pusan National University Hospital, 305 Guduk-ro, Seo-gu, Busan 602-739, Korea.
Br J Dermatol. 2012 Dec;167(6):1382-5. doi: 10.1111/j.1365-2133.2012.11124.x.
Dermatoscopy is a noninvasive technique that can be helpful in the diagnosis of pigmented and nonpigmented skin tumours. The dermatoscopic evaluation of Bowen disease (BD) improves diagnostic accuracy.
To evaluate the usefulness of dermatoscopy as a tool for assessing responses to therapy and recurrence of BD.
Patients with histopathologically diagnosed BD were prospectively enrolled. In all lesions, 3 months after the end of treatment (photodynamic therapy or 5% imiquimod cream), dermatoscopic and histopathological examinations were repeated to evaluate and correlate changes in dermatoscopic features and histopathological results. Cured lesions were monitored using dermatoscopy during the follow-up period.
A total of 23 patients with 29 histopathologically diagnosed BD lesions were included in this study. After treatment, dermatoscopic examination revealed the disappearance of pre-existing vascular structures in 16 lesions, and remaining vascular structures in 13 lesions. Histopathological evaluation of the treated lesions showed remnant intraepithelial neoplasms and increased dermal vascularity in lesions with persistent dermatoscopic vascular structures. However, normal epidermis and decreased dermal vascularity were observed in all but one of the lesions without previous dermatoscopic vascular structures. During the follow-up period, one lesion showed reappearance of previous vascular structures on dermatoscopy 9 months after treatment. Histopathological examination confirmed the recurrence of BD.
Our study demonstrates that the persistence of dermatoscopic vascular structures of BD appears to be associated with residual disease, and disappearance of vascular structures suggests that the disease has been cured. In addition, reappearance of previous dermatoscopic vascular structures indicates the recurrence of BD. Therefore, we suggest that dermatoscopy can be a useful, reliable and noninvasive tool in the therapeutic follow-up of BD.
皮肤镜检查是一种非侵入性技术，有助于诊断色素性和非色素性皮肤肿瘤。对 Bowen 病（BD）的皮肤镜评估可提高诊断准确性。
评估皮肤镜作为评估 BD 治疗反应和复发的工具的有用性。
前瞻性纳入组织病理学诊断为 BD 的患者。在所有病变中，在治疗结束后 3 个月（光动力疗法或 5%咪喹莫特乳膏），重复进行皮肤镜和组织病理学检查，以评估和关联皮肤镜特征和组织病理学结果的变化。在随访期间，使用皮肤镜监测治愈的病变。
共有 23 例患者 29 处组织病理学诊断为 BD 的病变纳入本研究。治疗后，16 处病变的皮肤镜检查显示先前存在的血管结构消失，13 处病变仍存在血管结构。治疗病变的组织病理学评估显示，残留的上皮内肿瘤和持续存在皮肤镜血管结构的病变中真皮血管增多。然而，除了一处先前无皮肤镜血管结构的病变外，所有病变均显示正常表皮和真皮血管减少。在随访期间，1 处病变在治疗后 9 个月的皮肤镜检查中显示先前血管结构的重现。组织病理学检查证实 BD 复发。
我们的研究表明，BD 的皮肤镜血管结构的持续存在似乎与残留疾病相关，血管结构的消失表明疾病已治愈。此外，先前皮肤镜血管结构的重现表明 BD 的复发。因此，我们建议皮肤镜可以作为 BD 治疗随访的一种有用、可靠和非侵入性的工具。
