Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Physiopathology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
J Eur Acad Dermatol Venereol. 2018 Aug;32(8):1263-1271. doi: 10.1111/jdv.14729. Epub 2017 Dec 28.
Poromas are benign cutaneous sweat gland tumours that are challenging to identify. The dermoscopic features of poromas are not well characterized.
To determine the clinical-dermoscopic features of poromas.
Cross-sectional, observational study of 113 poromas and 106 matched control lesions from 16 contributors and eight countries. Blinded reviewers evaluated the clinical and dermoscopic features present in each clinical and dermoscopic image.
Poromas were most commonly non-pigmented (85.8%), papules (35.4%) and located on non-acral sites (65.5%). In multivariate analysis, dermoscopic features associated with poroma included white interlacing areas around vessels (OR: 7.9, 95% CI: 1.9-32.5, P = 0.004), yellow structureless areas (OR: 2.5, 95% CI: 1.1-6.0, P = 0.04), milky-red globules (OR: 3.9, 95% CI: 1.4-11.1, P = 0.01) and poorly visualized vessels (OR: 33.3, 95% CI: 1.9-586.5, P = 0.02). The presence of branched vessels with rounded endings was positively associated with poromas but did not reach statistical significance (OR: 2.4, 95% CI: 0.8-6.5, P = 0.10). The presence of any of these five features was associated with a sensitivity and specificity of 62.8% and 82.0%, respectively.
We identified dermoscopic features that are specific to the diagnosis of poroma. Overall, however, the prevalence of these features was low. Significant clinical and dermoscopic variability is a hallmark of these uncommon tumours, which are most prevalent on non-acral sites.
汗管瘤是良性皮肤汗腺肿瘤,难以识别。汗管瘤的皮肤镜特征尚未得到很好的描述。
确定汗管瘤的临床皮肤镜特征。
这是一项来自 16 名贡献者和 8 个国家的 113 例汗管瘤和 106 例匹配对照病变的横断面、观察性研究。盲法审查员评估了每个临床和皮肤镜图像中存在的临床和皮肤镜特征。
汗管瘤最常见的是非色素性(85.8%)、丘疹(35.4%)和位于非肢端部位(65.5%)。多变量分析显示,与汗管瘤相关的皮肤镜特征包括血管周围的白色交织区域(OR:7.9,95%CI:1.9-32.5,P=0.004)、黄色无结构区域(OR:2.5,95%CI:1.1-6.0,P=0.04)、乳白色红色小球(OR:3.9,95%CI:1.4-11.1,P=0.01)和血管显示不佳(OR:33.3,95%CI:1.9-586.5,P=0.02)。分支血管伴圆形末端的存在与汗管瘤呈正相关,但未达到统计学意义(OR:2.4,95%CI:0.8-6.5,P=0.10)。存在任何这五种特征与敏感性和特异性分别为 62.8%和 82.0%相关。
我们确定了特定于汗管瘤诊断的皮肤镜特征。然而,总体而言,这些特征的出现频率较低。这些罕见肿瘤的一个显著特征是具有显著的临床和皮肤镜变异性,最常见于非肢端部位。