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皮肤镜检查在海分枝杆菌感染中的应用及其与临床和组织病理学特征的相关性:一项前瞻性观察研究。

Dermoscopy in Mycobacterium marinum infection and its correlation with clinical and histopathological features: a prospective observational study.

机构信息

Department of Dermatology, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China.

Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.

出版信息

Clin Exp Dermatol. 2023 Feb 2;48(2):89-95. doi: 10.1093/ced/llac029.

Abstract

BACKGROUND

Mycobacterium marinum is a nontuberculous mycobacterium and a conditional pathogen to humans, which can be inoculated directly and cause chronic skin granulomas. Dermoscopy has been applied to other granulomatous skin diseases, but not to M. marinum infection.

AIM

To explore the dermoscopic features of M. marinum infection, and its correlation with clinical and histopathological features.

METHODS

In total, 27 lesions from 27 patients (19 women, 8 men, age range 28-71 years) diagnosed with M. marinum infection were identified by clinical examination, histopathological results, PCR sequencing and mycobacterial culture in the dermatology outpatient department of our hospital from March 2020 to February 2022. The dermoscopy images and pathological characteristics were analysed.

RESULTS

Lesions were located on the hands, forearms and upper arms. The following dermoscopic features were observed: yellowish-orange structureless areas (85·2%), white striped structures (59·3%), follicular plugs (29·6%), yellowish oval clods (14·8%) and reddish or pinkish areas (14·8%). Vessel structures were visible in all cases: long hairpin vessels (81·5%), corkscrew vessels (25·9%), comma-shaped vessels (22·2%) and linear vessels (22·2%).

CONCLUSION

Yellowish-orange structureless areas, white striped structures and long hairpin vessels are the most common dermoscopic features of M. marinum infection. Thus, dermoscopy could be used as a noninvasive auxiliary diagnostic method to provide a diagnostic basis for this disease.

摘要

背景

海分枝杆菌是非结核分枝杆菌,也是人类的条件致病菌,可直接接种引起慢性皮肤肉芽肿。皮肤镜已应用于其他肉芽肿性皮肤病,但尚未应用于海分枝杆菌感染。

目的

探讨海分枝杆菌感染的皮肤镜特征及其与临床和组织病理学特征的相关性。

方法

本研究回顾性分析了 2020 年 3 月至 2022 年 2 月在我院皮肤科门诊经临床检查、组织病理学结果、PCR 测序和分枝杆菌培养诊断为海分枝杆菌感染的 27 例(19 例女性,8 例男性;年龄 28-71 岁)27 处皮损的皮肤镜图像和病理特征。

结果

皮损位于手部、前臂和上臂。观察到以下皮肤镜特征:黄色-橙色无结构区(85.2%)、白色条纹结构(59.3%)、毛囊塞(29.6%)、黄色椭圆形团块(14.8%)和红色或粉红色区域(14.8%)。所有病例均可见血管结构:长发夹状血管(81.5%)、螺旋状血管(25.9%)、逗号状血管(22.2%)和线性血管(22.2%)。

结论

黄色-橙色无结构区、白色条纹结构和长发夹状血管是海分枝杆菌感染最常见的皮肤镜特征。因此,皮肤镜检查可作为一种非侵入性辅助诊断方法,为该疾病提供诊断依据。

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