类扁平疣脂溢性角化病的皮肤镜学表现

发布时间：2018-05-15 04:38

本文选题：脂溢性角化病 + 皮肤镜学　；参考：《郑州大学》2011年硕士论文

【摘要】：背景和目的脂溢性角化病(seborrheic keratosis SK)是由于角质细胞成熟迟缓所致的一种良性表皮内肿瘤,好发于中老年人。非典型SK尤其是类扁平疣的SK可能与扁平疣相混淆,尤其是发生于老年人的扁平疣以及发生于青少年的类扁平疣SK。然而这却是预后及治疗明显不同的两种疾病,扁平疣有自限性或者常年保持扁平形态,而SK随着年龄的增长数目及大小均会增加,甚至增生明显,还可能与某些恶性肿瘤有关。皮肤镜作为一种无创性并且简便易行的检查工具被广泛应用于色素性皮肤疾病以及某些炎症性疾病的诊断与鉴别诊断如：多形红斑、扁平苔藓、银屑病、紫癜、玫瑰糠疹、鲍温样丘疹病等等。其可以直接观察到皮损部位的细微结构,为皮肤形态学研究开辟了一篇崭新的领域。在减少不必要的活检、方便疾病随访与图象资料的保存与提取方面有着明显的优势。关于SK的皮肤镜临床检查方面国内外已有相当一部分的研究,也一致认可了皮肤镜在SK的应用价值。SK的皮肤镜学表现主要有：粉刺样开口、粟粒样囊肿、发夹样血管、脑裂样结构、虫蚀样边界以及锋利而清晰的边界线。其中粉刺样开口及粟粒样囊肿是两种经典而常见的结构。但是关于类扁平疣型SK的皮肤镜学表现目前尚未专门研究总结。因此本次研究的目的在于观察并统计分析类扁平疣型SK的皮肤镜学表现,为皮肤镜鉴别类扁平疣型SK与扁平疣奠定基础。方法 1、搜集自2010年3月至2010年12月在我院皮肤性病科门诊及我院体检科门诊就诊的类扁平疣脂溢性角化病患者49位皮损105例。入选皮损标准：能够临床及皮肤镜确诊的脂溢性角化病患者,选择其临床类似扁平疣的扁平皮损图片,排除临床不能确诊病例以及任何能够明确诊断为其他色素性皮肤疾病如：色素痣、雀斑样痣、黑素瘤、日光性角化以及扁平疣。然后有具有丰富皮肤镜临床应用经验的医生对所有皮镜照片分析总结,做出诊断并统计分析出皮肤镜特征。 2、统计指标：统计分析入选类扁平疣型SK皮损发病部位、形态、颜色以及皮肤镜表现发生率。结果 1.本项研究中的49位患者105例类扁平疣性SK皮损,其中男性28例(57.14%),女性21例(42.86%),男女比例约为1.33：1,就诊年龄29～85岁,平均就诊年龄为63.94±1.89岁。多发者有93(88.57%)例之多,单发者有12(11.43%)例。 2.在入选的所有105例皮损皮肤镜学表现中,27(25.71%)例为匀质结构。34(32.38%)例皮损为斑点状结构,其中20例伴有不同程度的角化,表现为点状角化和网状角化,或有膜样结构覆盖与表层。27(25.71%)例为点状结构。12(11.43%)例皮损为脑裂状结构,4(3.81%)例为井田状结构,1(0.95%)例为蕾丝状结构。 3.所观察到的含有局部结构的皮损有40(38.10%)例,局部结构有：点状血管、粉刺样开口、虫蚀状边界、放射状结构、网状结构、毛囊口角化、指纹状结构、蓝白色面纱。结论 1类扁平疣脂溢性角化病皮损皮肤镜学大体结构包括匀质状结构、斑点状、点状结构、井田状结构、脑裂样结构和蕾丝样结构。 2、类扁平疣脂溢性角化病皮损皮肤镜学局部结构包括点状血管、指纹状结构、放射状结构和粉刺样开口。
[Abstract]:Background and Purpose

It is a kind of benign intraepidermal tumor due to the delayed maturation of keratinocytes . SK in atypical SK , especially flat wart , may be confused with flat wart , especially in the elderly . However , this is the two kinds of diseases which have different prognosis and treatment . However , the number and size of SK increases with age , even hyperplasia is obvious , it may be related to certain malignant tumors .

As a non - invasive and easy - to - line inspection tool , the skin mirror is widely used in the diagnosis and differential diagnosis of pigmented skin diseases and certain inflammatory diseases such as erythema multiforme , lichen mosses , psoriasis , purpura , pityriasis pityriasis , Bowen - like papulosis , etc . It can directly observe the fine structure of skin lesions , and opens up a new field for the study of skin morphology . It has obvious advantages in reducing unnecessary biopsies , facilitating the follow - up of disease and preserving and extracting image data .

There are quite a few researches on SK ' s skin mirror clinical examination at home and abroad , and the application value of the skin mirror in SK has been approved . The main features of SK are as follows : acne - like opening , millet - like cyst , hairpin - like blood vessel , brain fissure - like structure , worm - like boundary and sharp and clear boundary line .

method

1 . From March 2010 to December 2010 , there were 105 lesions in 49 lesions in the patients who were diagnosed by the dermatological department of the Department of Dermatology of our hospital and the medical examination department of our hospital .

2 . Statistical indicators : Statistical analysis of the incidence of the disease site , morphology , color and the appearance of skin mirror in patients with flat wart type SK lesions .

Results

1 . Among the 49 patients in this study , there were 105 cases of flat wart SK lesions , including 28 males ( 57.14 % ) , 21 females ( 42.86 % ) , male and female ratio of about 1.33 : 1 , age 29 - 85 years , average age 63.94 卤 1 . 89 years old . There were 93 ( 88.57 % ) cases with multiple hair and 12 ( 11.43 % ) cases with single hair .

2 . Of all 105 cases of skin lesions , 27 ( 25.71 % ) cases were homogeneous structures . 34 ( 32.38 % ) cases were spot - like structures , 20 of them were accompanied by different degrees of cutinization , in which 20 cases were keratotic and reticular , or with membrane - like structure covering and superficial layer . 27 ( 25.71 % ) cases were punctate structures .

3 . There were 40 ( 38.10 % ) cases of lesions with local structure . The local structures were punctate blood vessels , acne - like openings , wormlike boundaries , radial structures , reticular structures , hair follicle openings , fingerprint - like structures , and blue - white veil .

Conclusion

The general structure of the lesions of the skin lesions of the type 1 flat wart is homogeneous structure , spot shape , punctate structure , well field structure , brain crack - like structure and lace - like structure .

2 . The local structure of the skin - loss skin mirror of the lipofusogenic keratoderma of the type flat wart includes the point - shaped blood vessel , the fingerprint - like structure , the radial structure and the acne - like opening .

【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.5

【相似文献】