Department of Dermatology, Air Force Medical Center, PLA, No.30 Fucheng Road, Beijing 100142, PR China.
Department of Dermatology, Air Force Medical Center, PLA, No.30 Fucheng Road, Beijing 100142, PR China.
Photodiagnosis Photodyn Ther. 2024 Oct;49:104351. doi: 10.1016/j.pdpdt.2024.104351. Epub 2024 Oct 2.
We report a rare case of large facial hyperpigmentation in a 25-year-old female. Starting one month after birth, the patient developed a blue-brown patch on the right side of her face, interspersed with black macules and papules. As she aged, the lesion progressively enlarged and darkened, eventually covering the entire right side of her face. Dermoscopic and reflectance confocal microscopy examinations indicated nevus spilus in some areas and nevus of Ota in others, leading to a definitive diagnosis of overlapping nevus spilus and nevus of Ota. With no signs of malignant transformation on clinical or imaging examination, successful treatment was achieved using Q-switched alexandrite laser without any adverse effects. Our case underscores the critical value of dermoscopy and reflectance confocal microscopy in diagnosing rare facial pigmentary conditions, as we compare the imaging characteristics of nevus spilus, nevus of Ota, and similar conditions, alongside their clinical and histopathological correlations. Furthermore, our findings highlight the significant role of imaging examinations in monitoring malignancy and guiding treatment decisions.
我们报告了一例罕见的 25 岁女性面部大面积色素沉着过度病例。自出生后 1 个月起，患者右侧面部出现了一块蓝棕色斑块，其间散布着黑色斑点和丘疹。随着年龄的增长，病变逐渐扩大并加深，最终覆盖了整个右侧面部。皮肤镜和反射共聚焦显微镜检查显示部分区域为痣样神经纤维瘤，部分区域为太田痣，最终明确诊断为痣样神经纤维瘤和太田痣重叠。临床和影像学检查未见恶性转化迹象，采用 Q 开关紫翠宝石激光治疗取得了成功，且无不良反应。我们的病例强调了皮肤镜和反射共聚焦显微镜在诊断罕见面部色素性疾病中的重要价值，我们比较了痣样神经纤维瘤、太田痣及类似疾病的影像学特征及其临床和组织病理学相关性。此外，我们的发现强调了影像学检查在监测恶性肿瘤和指导治疗决策方面的重要作用。
