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利用皮肤镜和高频超声观察皮肤T细胞淋巴瘤的形态学特征

Morphologic Features of Cutaneous T-Cell Lymphomas Using Dermoscopy and High Frequency Ultrasound.

作者信息

Wohlmuth-Wieser Iris, Ramjist Joel M, Shear Neil, Alhusayen Raed

机构信息

Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Center, Toronto, ON M4N 3M5, Canada.

Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.

出版信息

J Clin Med. 2020 Dec 23;10(1):17. doi: 10.3390/jcm10010017.

Abstract

The diagnosis of cutaneous T-cell lymphomas (CTCL) is frequently delayed by a median of three years and requires the clinical evaluation of an experienced dermatologist and a confirmatory skin biopsy. Dermoscopy and high-frequency ultrasound (HFUS) represent two non-invasive diagnostic tools. While dermoscopy is inexpensive and widely used for the diagnosis of melanoma and non-melanoma skin cancers, HFUS of skin lymphomas represents a novel diagnostic approach that is not yet implemented in the routine dermatologic practice. The aim of our study was to prospectively assess skin lesions of patients with either CTCL patches or plaques with dermoscopy and HFUS and to compare the findings with atopic dermatitis (AD) and psoriasis. Thirteen patients with an established diagnosis of CTCL, psoriasis, or AD were studied: Dermoscopy features including spermatozoa-like structures and the presence of white scales could assist in differentiating between early-stage CTCL and AD. HFUS measurements of the skin thickness indicated increased epidermal-, thickness in CTCL, and psoriasis compared with AD. Our results support the use of dermoscopy as a useful tool to diagnose CTCL. HFUS could augment the dermatologic assessment, but further studies will be needed to define standardized parameters.

摘要

皮肤T细胞淋巴瘤(CTCL)的诊断常常会被延迟,中位延迟时间为三年,且需要经验丰富的皮肤科医生进行临床评估并辅以确诊性皮肤活检。皮肤镜检查和高频超声(HFUS)是两种非侵入性诊断工具。虽然皮肤镜检查成本低廉且广泛应用于黑色素瘤和非黑色素瘤皮肤癌的诊断,但皮肤淋巴瘤的高频超声检查是一种尚未在常规皮肤科实践中应用的新型诊断方法。我们研究的目的是通过皮肤镜检查和高频超声检查对患有CTCL斑片或斑块的患者的皮肤病变进行前瞻性评估,并将结果与特应性皮炎(AD)和银屑病进行比较。我们对13例已确诊为CTCL、银屑病或AD的患者进行了研究:皮肤镜检查特征,包括精子样结构和白色鳞屑的存在,有助于区分早期CTCL和AD。与AD相比,CTCL和银屑病的皮肤厚度的高频超声测量结果显示表皮厚度增加。我们的结果支持将皮肤镜检查作为诊断CTCL的有用工具。高频超声检查可增强皮肤科评估,但需要进一步研究以确定标准化参数。

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