组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2022, Vol. 18 ›› Issue (2): 127-.

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汉族人群获得性黑素细胞痣皮肤镜模式特点分析

  

  • 出版日期:2022-04-01 发布日期:2022-06-21

Analysis of dermatoscopic patterns and characteristics of acquired melanocytic nevus in Chinese Han Population　

  • Online:2022-04-01 Published:2022-06-21

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摘要： 目的　研究汉族人群中获得性黑素细胞痣的皮肤镜模式特征。方法　收集2020年12月至2021年3月病理确诊为获得性黑素细胞痣患者的皮肤影像资料，回顾性分析皮肤镜模式与患者的年龄、直径、部位、病理之间的相关性。结果　收集1 463例患者，共1 918处皮损，男女比0.35∶1，年龄4~75岁，20~40岁组（69.2%）最多。最常见的皮肤镜模式为球状模式（37.1%）和假网状模式（36.8%）。<20岁者最常见的是假网状模式（41.0%），≥20岁则是球状模式，且球状模式在<20岁与≥20岁组间的分布存在统计学差异（P<0.05）。5~9 mm组皮损最多，其中又以假网状模式（36.7%）及球状模式（35.8%）最多见。皮肤镜模式与分布部位有明显相关性（P<0.001），头面颈部最常见为假网状模式（99.3%），躯干最常见为球状模式（62.1%），而皮沟平行模式、纤维样模式、网格模式只见于四肢及掌跖。病理表现以皮内痣最多，网状模式和皮沟平行模式在各病理类型中的构成比有显著差异（P<0.05）。结论　获得性黑素细胞痣的皮肤镜模式与患者年龄、直径、部位均存在一定的相关性，虽然与病理类型不能一一对应，但在良恶性色素性肿瘤的鉴别中仍然具有不可替代的作用，并可在临床上有效减少非必要的组织学活检或手术。

关键词: 获得性黑素细胞痣, 　皮肤镜模式, 　年龄, 　直径, 　部位, 　皮肤病理

Abstract: Objective　To analyze dermatoscopic patterns and characteristics of acquired melanocyte nevus (AMN) in Chinese Han population. Methods　Clinical data and dermatoscopic findings of patients with pathologically confirmed acquired melanocytic nevus from December 2020 to March 2021 were collected, and the correlation between the dermatoscopic pattern and age, diameter, location and pathology was retrospectively analyzed. Results　A total of 1 918 lesions were collected from 1 463 patients, with a male to female ratio of 0.35:1. The age distribution was from 4 to 75 years old, and the 20 to 40 years old group(69.2%) was the largest. The most common dermatoscopic patterns were spherical (37.1%) and pseudoreticular(36.8%).  Pseudoreticular pattern was most common in <20 years old group(41.0%) whereas spherical pattern in ≥20 years old group(P<0.05).  The most lesions were found in 5~9 mm group, and pseudoreticular pattern(36.7%) and spherical pattern (35.8%) were the first two patterns in it. The dermatoscopic pattern was significantly correlated with the site on body surface (P<0.001). The most common pattern was pseudoreticular pattern in head, face and neck (99.3%), spherical pattern in trunk (62.1%), while the cutaneous furrow parallel pattern, fibrillar pattern and grid pattern were only found in limbs and palmoplantar. Intradermal nevus was the most common pathological type, and there were significant differences in the composition ratio of reticular pattern and parallel sulcus pattern among pathological types(P<0.05).  Conclusion　The dermatoscopic pattern of acquired melanocytic nevus has certain correlation with age, diameter and location. Although it cannot correspond with histopathology one by one, it still plays an irreplaceable role in the differentiation of benign and malignant pigmented lesions, and can reduce the probability of unnecessary biopsy or surgical treatment.

Key words: Acquired melanocytic nevi, 　Dermatoscopic pattern, 　Age, 　Diameter, 　Location, 　Histological subtype