中华皮肤科杂志 ›› 2009, Vol. 42 ›› Issue (12): 810-813.

• 论著 • 上一篇    下一篇

偏振光皮肤镜在白癜风早期诊断及与其他色素减退斑鉴别中的应用

孟如松1,赵广1,蔡瑞康2,等3   

  1. 1. 中国人民解放军空军总医院皮肤科 100142
    2. 中国人民解放军空军总医院皮肤科
    3. 北京首都医科大学100069
  • 收稿日期:2008-12-18 修回日期:2009-03-10 出版日期:2009-12-15 发布日期:2012-03-27
  • 通讯作者: 孟如松 E-mail:mrs5822@sohu.com
  • 作者简介:  从事皮肤组织病理、显微细胞图像和皮肤镜图像分析技术等医疗、科研和教学工作。近年,在显微图像和皮肤镜图像分析技术的临床开发与应用研究取得满意成绩,并以第一作者荣获部级以上科研成果奖4,包括:军队和北京市科技进步二等奖2,三等奖2项。擅长采用皮肤镜图像分析技术在临床诊断中的应用。
  • 基金资助:

    国家自然科学基金项目(基金编号60672152);国家自然科学基金资助项目(编号)

Application of polarized light dermoscopy in the early diagnosis of vitiligo and its differential diagnosis from other depigmented diseases

  • Received:2008-12-18 Revised:2009-03-10 Online:2009-12-15 Published:2012-03-27

摘要:

目的 探讨偏振光皮肤镜图像分析技术在白癜风早期诊断中的应用及与其他色素减退斑的鉴别。方法 收集局限性色素减退斑患者,采用偏振光皮肤镜观察皮损微观形态、特征和颜色;所选病例除花斑糠疹经临床与实验室检查确诊外,其余病例均经病理活检确诊。结果 176例患者中,白癜风97例,进展期毛周色素残留发生率达91.94%,显著高于稳定期(62.86%),两者之间差异有统计学意义(P < 0.05);毛细血管扩张、早期色素岛形成和皮周色素加深等与病程和近期有无治疗有关。79例色素减退斑,包括花斑糠疹、炎症后色素减退、白色糠疹、老年性白斑、无色素痣、贫血痣和特发性滴状色素减退症,未见毛周色素残留。结论 偏振光皮肤镜有效地排除了白癜风皮损中的反射光干扰,是一种可直接观察到肉眼不可见微细结构与特征的影像技术;对白癜风的早期诊断及与其他色素减退斑相鉴别提供了参考依据。

关键词: 色素减退

Abstract:

Objective To investigate the early diagnosis of vitiligo and its differential diagnosis from other depigmentated diseases using polarized light dermoscopy (PD) imaging analysis. Methods Patients with localized depigmented macules were enrolled into this study. PD was used to observe the micromorphology, feature and color of skin lesions. Histopathology was performed to confirm the diagnosis of all cases except for those of pityriasis versicolor which were confirmed by clinical and laboratory examination. Results Of the 176 patients, 97 were diagnosed as vitiligo. Residual perifollicular pigmentation was observed in 91.94% (57/62) of patients with progressing vitiligo and 62.86% (22/35) of those with stable vitiligo, with significant difference between the two groups of patients (P < 0.05). However, residual perifollicular pigmentation was absent in the 79 non-vitiligo depigmented cases. The presence of telangiectasia, early reservoirs of pigmentation and perilesional hyperpigmentation were related to the stage of vitiligo and treatment history of patients. Conclusions PD, which efficiently eliminates the interference of reflected light on skin lesions of vililigo, is an imaging technique that allows for the visualization of minor structures and features of the skin lesions that are indiscernible to naked eyes. In a nutshell, the application of PD has offered references to the early diagnosis of vitiligo and its differential diagnosis from other depigmentation diseases.

中图分类号: 

  • R730,261