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目的探讨临床上靶样含铁血黄素沉积性血管瘤(THH)在偏振光皮肤镜(PD)与反射式共聚焦激光扫描显微镜(RCM)下特征。方法对2015年1月至2017年1月来我院就诊73例患者的检查结果及病理资料进行回顾性统计分析。结果 73例患者中皮肤镜下均显示多个圆形至椭圆形结构的深色腔隙,其中56例患者皮周伴有紫红色淤血斑(晕),仅有2例皮损中心与紫红色淤血斑(晕)两者间的皮肤为淡黄褐色,从而显现出由三种颜色形成的靶样外观;RCM显示角化过度,棘层增生、肥厚,真皮乳头下见较多扩张的网眼状分布的较大腔隙。2例患者组织病理均具有真皮浅层可见增生的薄壁大腔的血管,扩张充血,真皮内增生的薄壁血管部位有程度不同的含铁血黄素沉积。结论临床不典型的THH表现较易混淆、误诊,而本文皮肤镜与RCM观察结果与组织病理诊断结果有较好的一致性,同时对减少盲目活检、有效指导手术切除范围及选择恰当的治疗方法以及对于本病只依赖于手术活检才能与色素痣、黑素瘤、色素性基底细胞癌等疾病相鉴别,在临床上具有一定意义。
Objective To investigate the clinical features of target hemosiderin-like hemangiomas (THH) under polarized dermoscopic (PD) and confocal laser scanning microscopy (RCM). Methods A retrospective statistical analysis was performed on the examination results and pathological data of 73 patients who came to our hospital from January 2015 to January 2017. Results In 73 cases of patients, all of them showed many dark-colored lacunas with a round or oval structure. Among them, 56 cases were accompanied by purplish red congestion (halo), and only 2 cases had lesion center and purple Gully stain (halo) between the two skin is pale brown, which showed the appearance of the target by the three colors formed; RCM showed hyperkeratosis, stratum spinosum, hypertrophy, dermal papillae more dilated mesh Distribution of larger lacuna. The histopathology of the two patients had thin-walled vessels with hyperplastic hyperplasia of the dermis, dilatation and congestion, and deposition of hemosiderin with varying degrees on the thin-walled vascular site of dermal hyperplasia. Conclusions The clinical manifestations of atypical THH are more likely to be confused and misdiagnosed. However, the findings of dermoscopy and RCM in this paper are in good agreement with the histopathological findings. In addition, blind biopsy can effectively reduce the range of surgical resection and select the appropriate treatment As well as for the disease depends only on biopsy and nevus melanoma, pigmented basal cell carcinoma and other diseases phase identification, has clinical significance.