Sławińska M, Sokołowska-Wojdyło M, Olszewska B, Nowicki R J, Sobjanek M, Zalaudek I
Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland.
Department of Dermatology, University of Trieste, Trieste, Italy.
J Eur Acad Dermatol Venereol. 2021 Jul;35(7):1470-1484. doi: 10.1111/jdv.17219. Epub 2021 Apr 27.
Dermoscopy and trichoscopy are non-invasive methods used as auxiliary tools in diagnostics of different dermatoses. To date, no systematic review concerning the utility of dermoscopy and trichoscopy in the diagnostics of primary cutaneous lymphomas has been published. The aim of this study was to summarize the current state of knowledge on this topic based on systematic search of PubMed database and related references published before 8th of August 2020. Besides dermoscopic features, type of dermoscope, polarization mode, magnification, number of cases and histopathological correlation were analysed. A total of 34 records were included into the final analysis, evaluating 141 patients diagnosed with primary cutaneous T-cell lymphomas and 70 patients with primary cutaneous B-cell lymphomas. Most of the analysed records evaluated dermoscopic features (n = 206); trichoscopy was analysed in only 5 cases. Structures most commonly observed in classical mycosis fungoides (n = 108) were fine short linear vessels/linear vessels, spermatozoa-like vessels and orange-yellow patchy areas. In folliculotropic mycosis fungoides (n = 12), most frequently observed were comedonal lesions/comedo openings/central keratotic plugs and white halo around hair follicles/perifollicular accentuation. Primary cutaneous marginal zone B-cell lymphoma (n = 42) and primary cutaneous follicle centre lymphoma (n = 20) most commonly presented with salmon-coloured background and fine short/linear irregular/serpentine vessels. For other PCL, with less than 10 cases reported in the analysed records, details have been provided in the article. Most observations analysed in this systematic review rely on findings from case reports/case series (with the level of evidence V) and lack a control group. A few studies provided information concerning technical aspects of dermoscopic/trichoscopic examination. The role of dermoscopy/trichoscopy in diagnostics of cutaneous lymphomas requires further studies, especially in entities where dermoscopic features have been described in only single or a few cases. However, it seems that this practical, accessory tool in future may provide additional clues during clinical assessment.
皮肤镜检查和毛发镜检查是用于不同皮肤病诊断的辅助性非侵入性方法。迄今为止，尚未发表关于皮肤镜检查和毛发镜检查在原发性皮肤淋巴瘤诊断中的应用的系统评价。本研究的目的是通过系统检索PubMed数据库以及2020年8月8日前发表的相关参考文献，总结该主题的当前知识状态。除了皮肤镜特征外，还分析了皮肤镜类型、偏振模式、放大倍数、病例数和组织病理学相关性。最终分析共纳入34条记录，评估了141例诊断为原发性皮肤T细胞淋巴瘤的患者和70例原发性皮肤B细胞淋巴瘤的患者。大多数分析记录评估了皮肤镜特征（n = 206）；仅5例分析了毛发镜检查。在经典蕈样肉芽肿（n = 108）中最常观察到的结构是细小的短线性血管/线性血管、精子样血管和橙黄色斑片区域。在亲毛囊性蕈样肉芽肿（n = 12）中，最常观察到的是粉刺样病变/粉刺开口/中央角质栓以及毛囊周围白色晕圈/毛囊周围明显。原发性皮肤边缘区B细胞淋巴瘤（n = 42）和原发性皮肤滤泡中心淋巴瘤（n = 20）最常表现为鲑鱼色背景和细小的短/线性不规则/蜿蜒血管。对于其他原发性皮肤淋巴瘤，分析记录中报告的病例少于10例，文章中提供了详细信息。本系统评价中分析的大多数观察结果依赖于病例报告/病例系列的结果（证据等级为V）且缺乏对照组。少数研究提供了关于皮肤镜/毛发镜检查技术方面的信息。皮肤镜/毛发镜检查在皮肤淋巴瘤诊断中的作用需要进一步研究，尤其是在仅在单个或少数病例中描述了皮肤镜特征的实体中。然而，在未来，这种实用的辅助工具似乎可能在临床评估中提供额外线索。
