Gowda Shreya K, Asati Dinesh P, Panwar Hemlata, Halder Ajay, Gupta Vikas, Lakshman Amulya M, Verma Priyanka, Denla Young
Department of Dermatology and Venereology, AIIMS, Habibganj, Saketnagar, Bhopal, Madhya Pradesh India.
Pathology and Laboratory Medicine, AIIMS, Habibganj, Saketnagar, Bhopal, Madhya Pradesh India.
Indian Dermatol Online J. 2024 Oct 28;15(6):955-962. doi: 10.4103/idoj.idoj_868_23. eCollection 2024 Nov-Dec.
Dermoscopy of mucosa is known as mucoscopy. Mucoscopy can aid in delineating minute aspects of mucosal lesions and will guide in the differentiation of similar-looking lesions. To date, there are only a few studies on mucoscopy of genital dermatoses especially from India.
The study aims to describe mucoscopic features and correlate histopathologically in various genital mucosal diseases.
The study was conducted in a tertiary care center in Central India after IHEC approval between October 2020 and April 2022, and the sampling technique was based on a convenience purposive method. Any genital mucosal diseases were included in patients above 18 years of age. Sexually transmitted diseases in general were excluded, however, warts and molluscum contagiosum were included. All patients fulfilling the inclusion criteria were examined after proper informed consent, and the clinical images were photographed using iPhone 11. Dermoscopic images were taken using a DermLite DL4 dermoscope in polarized mode at 10X magnification.
A total of 206 patients were recruited, and mucoscopy features were analyzed. Dermoscopic findings of physiological conditions such as vestibular papillomatosis, pearly penile papules, and Fordyce spots were evaluated. Inflammatory conditions such as lichen planus, pemphigus, and psoriasis were analyzed. Mucoscopy of lichen sclerosus showed white structureless areas (100%), follicular plugs (35%), as well as dotted and linear vessels (80%). Circinate balanitis revealed regular red dotted vessels (100%), coalescing pustules in annular and polycyclic patterns (90%). Squamous cell carcinoma of the penis showed ulceration, serpentine, looped vessels, white structureless area, and yellow-brown crust in a pink background.
In our study, because of the inclusion of various diseases, sample size was inadequate, biopsies were not performed in all cases, and variations in mucoscopic features in patients who are already on therapy could not be assessed. Haziness while capturing pictures because of mist formation was hindering the quality of pictures. As patients with premalignant and malignant cases were less, the predicting features for malignant transformation or pathognomoniic signs could not be assessed.
Various dermoscopies have been studied extensively, but the mucoscopy is still a gray area. The results of this study revealed the dermoscopic features of various genital disorders and histopathological correlation in few cases. However, biopsy was not performed in all mucosal disorders; hence, conclusive correlation could not be extrapolated.
黏膜皮肤镜检查被称为黏膜镜检查。黏膜镜检查有助于描绘黏膜病变的细微特征,并指导鉴别外观相似的病变。迄今为止,关于生殖器皮肤病的黏膜镜检查研究较少,尤其是来自印度的研究。
本研究旨在描述各种生殖器黏膜疾病的黏膜镜特征,并进行组织病理学相关性分析。
本研究于2020年10月至2022年4月在印度中部的一家三级医疗中心进行,经机构人类伦理委员会(IHEC)批准,采样技术基于便利目的抽样法。纳入18岁以上患有任何生殖器黏膜疾病的患者。一般排除性传播疾病,但包括疣和传染性软疣。所有符合纳入标准的患者在获得适当的知情同意后接受检查,使用iPhone 11拍摄临床图像。使用DermLite DL4皮肤镜在偏振模式下以10倍放大倍数拍摄皮肤镜图像。
共招募了206例患者,并对黏膜镜特征进行了分析。评估了前庭乳头状瘤、阴茎珍珠状丘疹和Fordyce斑等生理状况的皮肤镜表现。分析了扁平苔藓、天疱疮和银屑病等炎症性疾病。硬化性苔藓的黏膜镜表现为白色无结构区域(100%)、毛囊角栓(35%)以及点状和线状血管(80%)。环状龟头炎表现为规则的红色点状血管(100%),呈环状和多环状融合的脓疱(90%)。阴茎鳞状细胞癌表现为溃疡、蜿蜒状和环状血管、白色无结构区域以及粉红色背景下的黄褐色痂皮。
在我们的研究中,由于纳入了各种疾病,样本量不足,并非所有病例都进行了活检,并且无法评估正在接受治疗的患者黏膜镜特征的变化。由于雾气形成导致拍摄照片时模糊不清,影响了照片质量。由于癌前和恶性病例较少,无法评估恶性转化的预测特征或确诊体征。
各种皮肤镜检查已得到广泛研究,但黏膜镜检查仍是一个有待探索的领域。本研究结果揭示了各种生殖器疾病的皮肤镜特征以及少数病例的组织病理学相关性。然而,并非所有黏膜疾病都进行了活检;因此,无法得出确凿的相关性结论。