黑色丘疹性皮病18例临床特征总结及青年型脂溢性角化病的新命名

目的研究中国黄色人种所患的黑色丘疹性皮病的临床特征、皮肤镜、皮肤CT及组织病理学改变。方法回顾分析2014年8月-2018年2月在南方医科大学南方医院皮肤科就诊的18例黑色丘疹性皮病患者临床资料,对患者的性别、年龄、发病年龄、肤色分型、皮损分布、皮损特征(数目/大小/颜色)、家族史、皮肤镜、皮肤CT图像、组织病理学表现,以及采取的治疗和预后等情况进行总结分析。结果 18例黑色丘疹性皮病患者中,女16例,多在20岁左右发病,皮损对称,主要分布于面部两侧,泛发者可波及颧部、颊部、额部、颈部、头皮、眼睑及躯干,表现为肤色或淡褐色丘疹,表面散在针尖大小黑色或深褐色角质囊肿。皮肤镜下皮损表现为边界清楚的淡褐色,或呈脑回状外观,或呈指纹样结构,或呈网状结构,粉刺样开口较常见,无明显粟粒样囊肿及血管结构。皮肤CT提示棘层增厚,平扫呈脑回样结构或称肠管样结构,或见散在圆形或长条形开口角质囊肿。皮损组织病理类似棘层肥厚型脂溢性角化病。结论中国黑色丘疹性皮病女性多见,发病年龄较早,皮肤镜、皮肤CT和皮肤组织病理检查可辅助诊断。虽然该文的黑色丘疹性皮病与国外报道的是同一个病,但这是一个形态学命名,在中国人该病皮损形态上存在种族性差异,如仍延用黑色丘疹性皮病的形态学命名怕有不妥,建议命名为"青年型脂溢性角化病"。新命名有益于中国医生提高对该病诊断的接受度,从而提高该病诊断的准确率。

Dermatosis papulosa nigra in Chinese patients:A dermoscopic and reflectance confocal microscopic study

Objective Dermatosis papulosa nigra(DPN) is a benign epithelial condition which commonly occurs in darkerskinned individuals.Very few studies have reported DPN in Chinese.In this study conducted among Chinese,we described the clinical manifestations,dermoscopy and reflectance confocal microscopy(RCM) features of DPN.Methods Eighteen patients clinically diagnosed with DPN were recruited into the study.The detailed history of the patients was collected and thorough clinical examinations were carried out.The lesions were observed by a Dermlite DL4 dermoscopy and Vivascope 1500 RCM system,respectively.Results All the 18 patients were belonged to Fitzpatrick skin type Ⅲ.The ratio of females to males was 16 to 2.The average age of the cohort was(27.3±9.3) years.The lateral face was the most commonly affected site.The skin lesions exhibited as multiple skin-colored or light brown papules.The dermoscopic findings included fissures and ridges,comedo-like openings,networklike structures,homogeneous brown background,and fingerprint-like structures.The lesions observed by RCM presented increased thickness of stratum spinosum,stripped invaginations with or without keratin filled in,and round keratin-filled invaginations.Conclusion DPN is not a rare disease in adolescent Chinese patients.The most commonly affected site of DPN is the lateral aspects of the face,and it is easy to misdiagnose DPN as verruca plana in Chinese patients.The dermoscopy and RCM findings of DPN have characteristics which may be helpful in making a correct diagnosis.