Dermatology Department, Hospital Sant Pau i Santa Tecla, Tarragona, Spain.
Dermatology Department, Hospital Universitari Son Espases, Palma Mallorca, Spain.
J Eur Acad Dermatol Venereol. 2019 Apr;33(4):693-699. doi: 10.1111/jdv.15392. Epub 2019 Jan 9.
A variety of cutaneous smooth muscle neoplasms may arise in the skin and are frequently unrecognized by clinicians. There is sparse data relating to the dermoscopy of piloleiomyomas (PL), and nothing has been published about the dermoscopy of angioleiomyomas (AL) and leiomyosarcomas (LS).
To evaluate the morphological findings of a large series of cutaneous PL, AL and LS under dermoscopic observation, comparing these findings among them.
Digital dermoscopic images of 136 histopathologically confirmed cases of cutaneous smooth muscle neoplasms (114 PL, 13 AL and 9 LS) collected from 10 Hospitals in Spain, Austria and Italy were evaluated for the presence of dermoscopic structures and patterns.
The pattern composed of a symmetric, total delicate pigment network with the variable presence of multiple hypopigmented areas in a painful lesion is the most common dermoscopic pattern associated with PL. This pattern was found in 69.3% of PL and in no cases of AL and LS. The most common and characteristic pattern associated with AL was the one composed of symmetric pink-reddish tumour with vessels, white structures and the absence of ulceration, which was found in 46.2% of AL, but also in 3.5% of PL, and in 22.2% of LS. Finally, the most common pattern associated with LS was the one composed of an asymmetric, multilobulated tumour with linear-irregular or polymorphic-atypical vessels and white structures, which was found in 44.4% of cases, but also in 0.9% of PL and in 15.4% of AL.
Dermoscopy is helpful in improving the diagnostic accuracy of PL. The dermoscopic patterns associated with AL and LS were more variable and less specific.
多种皮肤平滑肌肿瘤可发生于皮肤，常被临床医生所忽视。有关毛发平滑肌瘤（PL）的皮肤镜特征的数据很少，而关于血管平滑肌瘤（AL）和平滑肌肉瘤（LS）的皮肤镜特征尚无报道。
评估在皮肤镜下观察到的大量皮肤 PL、AL 和 LS 的形态学发现，并比较它们之间的这些发现。
对来自西班牙、奥地利和意大利的 10 家医院的 136 例经组织病理学证实的皮肤平滑肌肿瘤（114 例 PL、13 例 AL 和 9 例 LS）的数字皮肤镜图像进行评估，以评估其皮肤镜结构和模式的存在。
由对称的、完全的纤细色素网组成，伴有多个色素减退区，疼痛性病变的模式是与 PL 最相关的最常见皮肤镜模式。这种模式在 69.3%的 PL 中发现，而在 AL 和 LS 中均未发现。与 AL 最相关的最常见和特征性模式是由对称的粉红色到红色肿瘤组成，伴有血管、白色结构和无溃疡，这种模式在 46.2%的 AL 中发现，但也在 3.5%的 PL 中发现，在 22.2%的 LS 中发现。最后，与 LS 最相关的模式是由不对称的、多叶状肿瘤组成，具有线性不规则或多形性不典型血管和白色结构，这种模式在 44.4%的病例中发现，但也在 0.9%的 PL 中发现，在 15.4%的 AL 中发现。
皮肤镜有助于提高 PL 的诊断准确性。与 AL 和 LS 相关的皮肤镜模式更加多变，特异性较低。
