Zhou Lu, Fu Yule, Huang Jian, Tang Zhen, Lu Jianyun, Tan Lina, Wang Dan, Zeng Jinrong, Wang Jia, Gao Lihua
Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha 410013.
Xiangya School of Medicine, Central South University, Changsha 410013, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2025 Mar 28;50(3):358-365. doi: 10.11817/j.issn.1672-7347.2025.240708.
Verrucous epidermal nevus (VEN), seborrheic keratosis (SK), verruca plana (VP), verruca vulgaris (VV), and nevus sebaceous (NS) are common verrucous proliferative skin diseases with similar clinical appearances, often posing diagnostic challenges. Dermoscopy and reflectance confocal microscopy (RCM) can aid in their differentiation, yet their specific features under these tools have not been systematically described. This study aims to summarize and analyze the dermoscopic and RCM features of VEN, SK, VP, VV, and NS.
A total of 121 patients with histopathologically confirmed verrucous proliferative skin diseases were enrolled. Dermoscopy and RCM imaging was used to observe and analyze the microscopic features of these conditions.
Under dermoscopy, the 5 diseases displayed distinct characteristics: VEN typically showed gyriform structures; SK was characterized by gyriform structures, comedo-like openings, and milia-like cysts; VP and VV featured dotted vessels and frogspawn-like structures; NS presented as brownish-yellow globules. RCM revealed shared features such as hyperkeratosis and acanthosis across all 5 diseases. Specific features included gyriform structures and elongated rete ridges in VEN; pseudocysts and gyriform structures in SK; evenly distributed ring-like structures in VP; vacuolated cells and papillomatous proliferation in VV; and frogspawn-like structures in NS.
These 5 verrucous proliferative skin conditions exhibit distinguishable features under both dermoscopy and RCM. The combination of these 2 noninvasive imaging modalities holds significant clinical value for the differential diagnosis of verrucous proliferative skin diseases.
疣状表皮痣（VEN）、脂溢性角化病（SK）、扁平疣（VP）、寻常疣（VV）和皮脂腺痣（NS）是常见的疣状增生性皮肤病，临床表现相似，常给诊断带来挑战。皮肤镜检查和反射式共聚焦显微镜（RCM）有助于它们的鉴别，但这些工具下它们的具体特征尚未得到系统描述。本研究旨在总结和分析VEN、SK、VP、VV和NS的皮肤镜及RCM特征。
共纳入121例经组织病理学确诊的疣状增生性皮肤病患者。采用皮肤镜检查和RCM成像观察分析这些疾病的微观特征。
在皮肤镜下，这5种疾病表现出不同特征：VEN通常表现为脑回状结构；SK的特征为脑回状结构、粉刺样开口和粟丘疹样囊肿；VP和VV以点状血管和蛙卵样结构为特征；NS表现为棕黄色小球。RCM显示所有5种疾病均有角化过度和棘层肥厚等共同特征。具体特征包括VEN中的脑回状结构和延长的 rete 嵴；SK中的假囊肿和脑回状结构；VP中均匀分布的环状结构；VV中的空泡化细胞和乳头瘤样增生；以及NS中的蛙卵样结构。
这5种疣状增生性皮肤病在皮肤镜检查和RCM下均表现出可区分的特征。这两种非侵入性成像方式的联合应用对疣状增生性皮肤病的鉴别诊断具有重要临床价值。
