Yu Shijuan, He Jingyi, Wang Hua
Department of Dermatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, China.
Department of Dermatology, The Seventh People's Hospital of Chongqing/The Central Hospital Affiliated to Chongqing University of Technology, Chongqing, China.
Front Pediatr. 2025 Jul 10;13:1550349. doi: 10.3389/fped.2025.1550349. eCollection 2025.
To analyze the application value of dermoscopy in the identification and staging evaluation of vitiligo in children.
We have analyzed the differences in dermoscopy between vitiligo and other hypopigmentation disorders. Meanwhile, the dermatoscopic differences between active and stable vitiligo were also compared. At the same time, the results of diagnosing vitiligo were compared between a single dermascopic image (testing paper) and a combination of photographs, Wood's lamp examinations, and dermascopic images (training paper) by answering a questionnaire to eight dermatologists.
We have summarized the dermatoscopic features and clinical characteristics of 112 cases of active vitiligo, 111 cases of stable vitiligo, 99 cases of pityriasis alba, 94 cases of depigmented nevi, 16 cases of sclerosing atrophic moss, and 42 cases of post-inflammatory hypopigmentation in children. In this study, a statistically significant difference ( < 0.05) was found in the dermatoscopic characteristics between vitiligo at different stages and several other pigmentary disorders. Meanwhile, the trichrome pattern at the periphery of the lesion [area under the curve (AUC) = 0.8834, sensitivity 89.19%, specificity 87.5%] and the micro-Koebner/comet tail phenomenon (AUC = 0.7812, sensitivity 99.1%, specificity 57.14%) showed better diagnostic efficacy for active vitiligo, while the pigmentation at the periphery of the lesion (AUC = 0.8746, sensitivity 91.89%, specificity 83.04%) showed better diagnostic efficacy for stable vitiligo. The mean score (79.75 ± 10.45 vs. 71 ± 3.85; = 0.058) and median time [555.50 (705) vs. 374 (1,011) s; = 1,000] for physicians completing training and testing papers showed no statistical difference.
Dermatoscopy can serve as a standalone tool for diagnosing vitiligo in children and may also help in staging the condition.
分析皮肤镜在儿童白癜风鉴别诊断及分期评估中的应用价值。
分析白癜风与其他色素减退性疾病在皮肤镜下的差异。同时，比较活动期和稳定期白癜风的皮肤镜差异。此外，通过向八位皮肤科医生发放问卷，比较单张皮肤镜图像（测试纸）与照片、伍德灯检查及皮肤镜图像组合（训练纸）诊断白癜风的结果。
总结了112例儿童活动期白癜风、111例稳定期白癜风、99例白色糠疹、94例色素脱失痣、16例硬化萎缩性苔藓及42例炎症后色素减退的皮肤镜特征及临床特点。本研究发现，不同分期的白癜风与其他几种色素性疾病在皮肤镜特征上存在统计学显著差异（<0.05）。同时，皮损周边三色模式[曲线下面积（AUC）=0.8834，敏感性89.19%，特异性87.5%]及微Koebner/彗尾现象（AUC=0.7812，敏感性99.1%，特异性57.14%）对活动期白癜风显示出较好的诊断效能，而皮损周边色素沉着（AUC=0.8746，敏感性91.89%，特异性83.04%）对稳定期白癜风显示出较好的诊断效能。医生完成训练纸和测试纸的平均得分（79.75±10.45 vs. 71±3.85；=0.058）及中位时间[555.50（705）vs. 374（1,011）s；=1,000]无统计学差异。
皮肤镜可作为诊断儿童白癜风的独立工具，也有助于对病情进行分期。
