Sławińska Martyna, Kaszuba Agnieszka, Lange Magdalena, Nowicki Roman J, Sobjanek Michał, Errichetti Enzo
Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 97-331 Gdańsk, Poland.
Department of Experimental and Clinical Medicine, Universita degli Studi di Udine, 33100 Udine, Italy.
J Clin Med. 2022 Aug 9;11(16):4649. doi: 10.3390/jcm11164649.
The term mastocytosis refers to a heterogeneous group of disorders characterised by accumulation of clonal mast cells in different organs, most commonly in the skin. Little is known about the role of dermoscopy in the diagnostics of mastocytosis. To date, no systematic review on the dermoscopic features of cutaneous mastocytosis has been performed. The aim of this study was to summarise the current knowledge in the field as well as to identify the knowledge gaps to show possible directions for further studies, based on a systematic search of PubMed, Scopus, and Web of Science databases and related references published before 3 January 2022. Dermoscopic features, type of dermoscope, polarisation mode, magnification, and number of cases were analysed. In total, 16 articles were included in this review (3 case series and 13 case reports), analysing 148 patients with different variants of cutaneous mastocytosis; all of the studies analysed had a low level of evidence (V). The main dermoscopic features of urticaria pigmentosa included brown structureless areas, brown lines arranged in a network, and linear vessels distributed in a reticular pattern, with this last finding also being typical of telangiectasia macularis eruptiva perstans. The presence of either circumscribed yellow structureless areas or diffuse yellowish background was a constant pattern of mastocytoma, while nodular, pseudoangiomatous xanthelasmoid, and plaque-type mastocytosis were typified by light-brown structureless areas and/or pigment network, though the first two variants also showed yellow/yellow-orange structureless areas. Finally, pigmented streaks of radial distribution surrounding hair follicles were described to be a pathognomonic dermoscopic feature of pseudoxanthomatous mastocytosis. Although this review shows that the various clinical forms of cutaneous mastocytosis may feature diagnostic dermoscopic clues, it also underlines the need for further investigation as several relevant data are missing, including evaluation of dermoscopic pattern according to anatomical locations or "lesion age", studies on rare mastocytosis variants, evaluation of the prognostic role of dermoscopy in the context of systemic involvement, and comparative analyses with common clinical mimickers.
肥大细胞增多症是一组异质性疾病，其特征是克隆性肥大细胞在不同器官中积聚，最常见于皮肤。关于皮肤镜检查在肥大细胞增多症诊断中的作用，人们了解甚少。迄今为止，尚未对皮肤肥大细胞增多症的皮肤镜特征进行系统评价。本研究的目的是基于对PubMed、Scopus和Web of Science数据库以及2022年1月3日前发表的相关参考文献的系统检索，总结该领域的现有知识，并找出知识空白，以显示进一步研究的可能方向。分析了皮肤镜特征、皮肤镜类型、偏振模式、放大倍数和病例数。本综述共纳入16篇文章（3个病例系列和13个病例报告），分析了148例不同类型皮肤肥大细胞增多症患者；所有纳入分析的研究证据水平都很低（V级）。色素性荨麻疹的主要皮肤镜特征包括棕色无结构区域、呈网状排列的棕色线条以及呈网状分布的线性血管，最后这一发现也是持久性斑疹性毛细血管扩张症的典型表现。局限性黄色无结构区域或弥漫性淡黄色背景的存在是肥大细胞瘤的恒定模式，而结节型、假性血管瘤样黄色瘤样和斑块型肥大细胞增多症的特征是浅棕色无结构区域和/或色素网络，不过前两种类型也显示黄色/黄橙色无结构区域。最后，围绕毛囊呈放射状分布的色素沉着条纹被描述为假黄瘤样肥大细胞增多症的特征性皮肤镜表现。尽管本综述表明皮肤肥大细胞增多症的各种临床形式可能具有诊断性皮肤镜线索，但它也强调了进一步研究的必要性，因为缺少一些相关数据，包括根据解剖位置或“皮损年龄”评估皮肤镜模式、对罕见肥大细胞增多症变体的研究、评估皮肤镜检查在全身受累情况下的预后作用以及与常见临床模仿疾病的比较分析。
