Correlation Between the Dermoscopic Features and the Histopathological Features of Common Erythematosquamous Skin Diseases: the Consensus Statement of Chinese Experts (2021)
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摘要: 皮肤镜作为一项无创且快速的辅助诊断技术，目前已广泛应用于红斑鳞屑性皮肤病的诊疗中，显著提高了临床工作效率及诊疗准确率。大多数皮肤病的皮肤镜特征与组织病理学特征存在关联，研究其关联性有助于加深对皮肤镜征象的理解。本共识基于国内外最新研究成果，对常见红斑鳞屑性皮肤病的皮肤镜与组织病理学特征相关性进行描述，以期提高皮肤科医师对此类疾病皮肤镜特征的认识。Abstract: As a non-invasive and rapid diagnostic tool, dermoscopy has been widely applied to erythematosquamous skin diseases, and has significantly improved the efficiency of clinical work and diagnostic accuracy. Most dermoscopic features of erythematosquamous skin diseases are associated with histopathological changes. Here a consensus was reached on the correlation between the dermoscopic features and the histopathological features of common erythematosquamous skin diseases, in order to improve the understanding of dermatologists on the dermoscopic features of erythematosquamous skin diseases.
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Key words:
- erythematosquamous skin disease /
- dermoscopy /
- histopathology /
- psoriasis /
- eczema
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图 2 银屑病皮肤镜与组织病理学典型特征
A.皮肤镜下可见亮红色背景上均匀分布的点状血管，可见白色鳞屑(偏振光浸润式，×20)；B.组织病理学可见表皮融合性角化不全(白色箭头)，颗粒层减少或消失，棘层增厚、皮突呈杵状下延，真皮乳头上延，乳头上方表皮变薄，真皮乳头层毛细血管扩张迂曲(黑色箭头)(HE，×100)
图 3 慢性湿疹/皮炎皮肤镜与组织病理学典型特征
A.皮肤镜下可见暗红色背景，非特异性分布的点状血管，伴黄白色鳞屑(箭头)(偏振光浸润式，×20)；B.组织病理学可见表皮轻度角化过度伴角化不全，棘层不规则肥厚，局部可见海绵水肿(箭头)，真皮浅层血管扩张，周围少量慢性炎症细胞浸润(HE，×100)
图 4 扁平苔藓皮肤镜与组织病理学典型特征
A.活动期皮肤镜下可见Wickham纹(箭头)，为相互交错的网状白色线条，周围可见少量点、线状血管(偏振光浸润式，×20)；B.消退期皮肤镜下可见皮损内弥漫分布棕色、蓝灰色点/球(箭头)(偏振光浸润式，×20)；C.活动期组织病理学可见表皮角化过度，颗粒层楔形增厚(箭头)，棘层肥厚，基底层灶性液化变性，真皮浅层水肿，血管扩张，可见以淋巴细胞为主的炎症细胞呈带状浸润(HE，×100)；D.消退期组织病理学可见基底层灶性液化变性及色素增加，真皮浅层有较多色素颗粒及噬黑素细胞(圆圈)(HE，×100)
图 5 玫瑰糠疹皮肤镜与组织病理学典型特征
A.皮肤镜下可见橘黄色背景下外周分布的白色鳞屑(偏振光非浸润式，×20)；B.组织病理学可见表皮角化过度及灶性角化不全，棘层不规则增厚，细胞内水肿，真皮浅层血管周围可见较多淋巴细胞浸润(HE，×100)
图 6 毛发红糠疹皮肤镜与组织病理学典型特征
A.皮肤镜下可见黄红色背景下，中央片状分布黄白色鳞屑、毛囊角栓、毛囊周围橙黄色晕及鳞屑(圆圈)，可见少量外周分布的点状血管(方框)(偏振光浸润式，×20)；B.组织病理学可见表皮角化过度与角化不全在水平和垂直方向上交替出现(箭头)，棘层不规则肥厚，真皮浅层血管扩张，周围少量淋巴细胞浸润(HE，×100)
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