Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy.
Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy -
Ital J Dermatol Venerol. 2024 Apr;159(2):135-145. doi: 10.23736/S2784-8671.24.07825-3.
Over the few last decades, dermoscopy has become an invaluable and popular imaging technique that complements the diagnostic armamentarium of dermatologists, being employed for both tumors and inflammatory diseases. Whereas distinction between neoplastic and inflammatory lesions is often straightforward based on clinical data, there are some scenarios that may be troublesome, e.g., solitary inflammatory lesions or tumors superimposed to a widespread inflammatory condition that may share macroscopic morphological findings.
We reviewed the literature to identify dermoscopic clues to support the differential diagnosis of clinically similar inflammatory and neoplastic skin lesions, also providing the histological background of such dermoscopic points of differentiation.
Dermoscopic differentiating features were identified for 12 relatively common challenging scenarios, including Bowen's disease and basal cell carcinoma vs. psoriasis and dermatitis, erythroplasia of Queyrat vs. inflammatory balanitis, mammary and extramammary Paget's disease vs. inflammatory mimickers, actinic keratoses vs. discoid lupus erythematosus, squamous cell carcinoma vs. hypertrophic lichen planus and lichen simplex chronicus, actinic cheilitis vs. inflammatory cheilitis, keratoacanthomas vs. prurigo nodularis, nodular lymphomas vs. pseudolymphomas and inflammatory mimickers, mycosis fungoides vs. parapsoriasis and inflammatory mimickers, angiosarcoma vs granuloma faciale, and Kaposi sarcoma vs pseudo-Kaposi.
Dermoscopy may be of aid in differentiating clinically similar inflammatory and neoplastic skin lesions.
在过去的几十年中,皮肤镜检查已成为一种非常有价值且流行的成像技术,可作为皮肤科医生诊断工具的补充,用于诊断肿瘤和炎症性疾病。虽然基于临床数据,区分肿瘤性和炎症性病变通常很简单,但有些情况下可能会很棘手,例如孤立性炎症性病变或肿瘤叠加在广泛的炎症性疾病上,这些病变可能具有相似的宏观形态学表现。
我们查阅了文献,以确定有助于鉴别临床相似的炎症性和肿瘤性皮肤病变的皮肤镜线索,并提供了这些皮肤镜鉴别点的组织学背景。
确定了 12 种相对常见的具有挑战性的情况的皮肤镜鉴别特征,包括 Bowen 病和基底细胞癌与银屑病和皮炎、Queyrat 红斑与炎症性龟头炎、乳房和外阴派杰病与炎症性类似物、光化性角化病与盘状红斑狼疮、鳞状细胞癌与肥厚性扁平苔藓和慢性单纯性苔藓、光化性唇炎与炎症性唇炎、角化棘皮瘤与结节性痒疹、结节性淋巴瘤与假性淋巴瘤和炎症性类似物、蕈样肉芽肿与副银屑病和炎症性类似物、血管肉瘤与颜面肉芽肿、卡波西肉瘤与假性卡波西肉瘤。
皮肤镜检查可辅助鉴别临床相似的炎症性和肿瘤性皮肤病变。