[皮肤镜在头皮银屑病和脂溢性皮炎诊断及鉴别诊断中的作用]

[Roles of dermoscopy in the diagnosis and differential diagnosis of scalp psoriasis and seborrheic dermatitis].

作者信息

Xu Chenchen, Chen Dian, Liu Jie, Liu Yuehua, Sun Qiuning

机构信息

Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2014 Dec 2;94(44):3467-70.

PMID:25622734

Abstract

OBJECTIVE

To describe the dermoscopic patterns of scalp psoriasis and seborrheic dermatitis and explore the roles of dermoscopy in their diagnosis and differential diagnosis.

METHODS

A total of 40 patients with scalp psoriasis (n = 20) and seborrheic dermatitis (n = 20) were recruited from Department of Dermatology, Peking Union Medical College Hospital from December 2013 to May 2014. They were examined both dermoscopically and histopathologically. And characteristic dermoscopic features were evaluated. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for predefined dermoscopic criteria in relation to the diagnosis of two diseases.

RESULTS

The most significant dermoscopic features of scalp psoriasis included dotted vessels (10/20, 50%), glomerular vessels (13/20, 65%), red loops (16/20, 80%), hairpin vessels (17/20, 85%), white scales (10/20, 50%) and punctate hemorrhages (12/20, 60%). In contrast, seborrheic dermatitis was characterized by arborizing vessels (16/20, 80%), atypical red vessels (13/20, 65%), featureless areas (20/20, 100%) and honeycomb pigment (9/20, 45%) (all P < 0.05).

CONCLUSIONS

Scalp psoriasis and seborrheic dermatitis have different dermoscopic patterns. Dermoscopy may be valuable for clinical diagnosis and differential diagnosis of scalp psoriasis and seborrheic dermatitis.

摘要

目的

描述头皮银屑病和脂溢性皮炎的皮肤镜表现，并探讨皮肤镜在其诊断及鉴别诊断中的作用。

方法

2013年12月至2014年5月，从北京协和医院皮肤科招募了40例头皮银屑病患者（n = 20）和脂溢性皮炎患者（n = 20）。对他们进行了皮肤镜检查和组织病理学检查，并评估了特征性皮肤镜特征。计算了针对两种疾病诊断的预定义皮肤镜标准的敏感性、特异性、阳性预测值和阴性预测值。

结果

头皮银屑病最显著的皮肤镜特征包括点状血管（10/20，50%）、肾小球样血管（13/20，65%）、红色袢（16/20，80%）、发夹样血管（17/20，85%）、白色鳞屑（10/20，50%）和点状出血（12/20，60%）。相比之下，脂溢性皮炎的特征为树枝状血管（16/20，80%）、非典型红色血管（13/20，65%）、无特征区（20/20，100%）和蜂窝状色素沉着（9/20，45%）（所有P < 0.05）。