Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Clin Exp Dermatol. 2019 Mar;44(2):169-175. doi: 10.1111/ced.13680. Epub 2018 Jun 6.
Early-stage mycosis fungoides (eMF) is a clinical diagnostic challenge because it can mimic inflammatory diseases. Dermoscopy has been reported to be useful in evaluation of eMF in Caucasian patients; however, dermoscopic features of eMF in the Chinese population are lacking.
To determine the validity of dermoscopy in the diagnosis and differential diagnosis of eMF in a Chinese population.
This was a retrospective study that included a total of 101 patients with eMF (n = 31), chronic dermatitis (CD; n = 36) or plaque psoriasis (PP; n = 34) who were examined dermoscopically, histopathologically and immunohistochemically. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for predefined dermoscopic criteria in relation to the diagnosis of eMF. In addition, CD34 immunohistochemistry was used to visualize dermal vessels to correlate dermoscopic features with histological changes.
Linear vessels (sensitivity 90.3%, specificity 92.9%), characteristic vascular structures resembling spermatozoa (sensitivity 74.2%, specificity 100%) and orange-yellowish patchy areas (sensitivity 90.3%, specificity 91.4%) were highly predictive for the diagnosis of eMF compared with CD and PP.
Dermoscopy shows great value in the diagnosis and differential diagnosis of eMF in a Chinese population.
早期蕈样真菌病(eMF)是一种临床诊断挑战,因为它可能模仿炎症性疾病。皮肤镜检查已被报道在评估白种人患者的 eMF 中有用;然而,缺乏中国人中 eMF 的皮肤镜特征。
确定皮肤镜检查在中国人中诊断和鉴别诊断 eMF 的有效性。
这是一项回顾性研究,共纳入 101 例 eMF(n = 31)、慢性皮炎(CD;n = 36)或斑块状银屑病(PP;n = 34)患者,对其进行皮肤镜、组织病理学和免疫组织化学检查。针对 eMF 诊断,计算了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。此外,还使用 CD34 免疫组化来可视化真皮血管,以将皮肤镜特征与组织学变化相关联。
与 CD 和 PP 相比,线性血管(敏感性 90.3%,特异性 92.9%)、类似精子的特征性血管结构(敏感性 74.2%,特异性 100%)和橙黄色斑片状区域(敏感性 90.3%,特异性 91.4%)对 eMF 的诊断具有高度预测价值。
皮肤镜检查在中国人中对 eMF 的诊断和鉴别诊断具有重要价值。