皮肤镜表现为落日征的Spitz痣1例

 患儿，女，1 岁。左眉弓上方内侧结节半个月。皮肤科查体：左眉弓上方内侧有一个半球形的红色结节，大小约 0.8 cm×0.6 cm，表面破溃、浆液性渗出，边界清楚。皮肤镜检查示红色均质背景，周边有黄白色鳞屑，呈现“落日征”。组织病理表现为表皮角化过度并角化不全，表皮假上皮瘤样增生，局部表皮高度水肿，水疱形成，表面可见浆痂。局部表皮内及真皮全层大量上皮样细胞增生，局部围绕附属器排列，细胞形态尚温和，偶见核裂。免疫组化：HMB-45(部分弱+)，Melan-A(-),S-100 （+），Ki-67 （3%+），CD163(-),CD68(-)。诊断：Spitz 痣。完整切除皮损，术后6个月随访，未见复发及转移。

Spitz nevus: a case report

  A 1-year old female presented with a reddish nodule on the left eyebrow arch for half a month.Physical examination showed a demarcated hemispherical reddish nodule, sized 0.8 cm×0.6 cm on the left eyebrow arch, with ulceration and serous exudate on the surface. The der moscopic characteristics were manifested by yellow and white scales on surface in the red background. Histologically, hyperkeratosis, dyskeratosis and pseudoepitheliomatous hyperplasia were observed in the psoriasis biopsies. No atypical cell hyperplasia was noticed while multiple epithelioid cells were seen at the dermis and epidermis which some around of the skin appendage. S-100 was highly expressed, HMB-45 and Ki-67 were lowly expressed, CD163, CD68 and Melan-A were negative.According to clinical and pathological features，the diagnosis of Spitz nevus was made.The tumor was surgically removed.Neither recurrence nor metastasis was seen during 6 month follow up.