Haliasos Elena C, Kerner Miryam, Jaimes-Lopez Natalia, Rudnicka Lidia, Zalaudek Iris, Malvehy Josep, Hofmann-Wellenhof Rainer, Braun Ralph P, Marghoob Ashfaq A
Memorial Sloan Kettering Cancer Center, Hauppauge, New York 11788, USA.
Pediatr Dermatol. 2013 Mar-Apr;30(2):163-71. doi: 10.1111/pde.12097. Epub 2013 Feb 14.
The dermoscope allows physicians to examine the macroscopic and microscopic primary morphology of skin lesions, identify subtle clinical clues, confirm naked-eye clinical diagnoses, and monitor treatment progress while posing little threat to the young patient. This review summarizes important dermoscopic structures seen in infectious and inflammatory skin conditions and hair disorders in children. Scabies, pediculosis, phthiriasis, molluscum contagiosum, tinea nigra, and verrucae are well characterized dermoscopically by delta-shaped structures, ovoid-shaped nits, the crab louse, red corona, brown strands or spicules, and multiple densely packed papilla with a central black dot surrounded by a whitish halo, respectively. These dermoscopic structures will be discussed, focusing on the dermoscopic morphologies and dermoscopic sensitivity for diagnosis and its utility in monitoring treatment progress. Dermoscopy has also been shown to significantly improve the clinician's diagnostic and monitoring accuracy of inflammatory skin lesions such as psoriasis, which is characterized dermoscopically by uniformly distributed dotted blood vessels, and lichen planus, which is characterized by whitish lines on a purple to reddish background. Dermoscopy of the hair and scalp (trichoscopy) facilitates the differential diagnosis of hair diseases in children, including alopecia areata, trichotillomania, and tinea capitis. It can also assist in the diagnosis of multiple genetic hair shaft disorders, such as monilethrix, trichorrhexis invaginata, trichorrhexis nodosa, pili torti, and pili annulati.
皮肤镜使医生能够检查皮肤病变的宏观和微观主要形态，识别细微的临床线索，确认肉眼临床诊断，并监测治疗进展，同时对年轻患者几乎不构成威胁。本综述总结了儿童感染性和炎症性皮肤病及毛发疾病中可见的重要皮肤镜结构。疥疮、虱病、阴虱病、传染性软疣、黑癣和疣在皮肤镜下分别具有特征性表现，即三角形结构、卵圆形虱卵、阴虱、红色晕、棕色条索或小刺，以及多个密集排列的乳头，中央有黑点，周围有白色晕圈。将对这些皮肤镜结构进行讨论，重点关注其皮肤镜形态、诊断的皮肤镜敏感性及其在监测治疗进展中的作用。皮肤镜还被证明能显著提高临床医生对炎症性皮肤病的诊断和监测准确性，如银屑病，其在皮肤镜下表现为均匀分布的点状血管；扁平苔藓，其在皮肤镜下表现为紫色至红色背景上的白色线条。毛发和头皮的皮肤镜检查（毛发镜检查）有助于儿童毛发疾病的鉴别诊断，包括斑秃、拔毛癖和头癣。它还可以辅助诊断多种遗传性毛发干疾病，如念珠状发、套叠性脆发、结节性脆发、扭曲发和环状发。
