摘要
目的了解儿童Hutchinson氏征阳性纵行黑甲的临床、皮肤镜及组织病理学特点,探索判断该类儿童纵行黑甲的性质及其管理。方法回顾性分析本科于2013年6月-2015年6月收治的Hutchinson氏征阳性纵行黑甲患儿的临床表现、皮肤镜和组织病理学特点。结果 32例患儿的平均年龄4岁6个月;男22例,女10例;平均病程2.5年。皮损部位:手指23例(其中8例发生于拇指),足趾9例,拇趾4例。Hutchinson氏征阳性部位:甲皱襞19例,甲下皮10例,二者皆有3例;黑素颗粒增多20例,色素痣12例,雀斑样痣3例。色带宽度≥3mm者22例。16例皮肤镜下见均一条带上伴规则的线状结构,12例同时伴规则线状结构和点球状结构,棕色及黑色均质模式分别为3例和1例。甲母质皮损组织病理示甲母痣27例,雀斑样痣5例。结论儿童期纵形黑甲多为黑素细胞良性增殖性病变,部分患儿需活检或手术方法确诊,以上临床特征和皮肤镜特点有助于诊断和随访。成人纵行黑甲有恶性风险的Hutchinson氏征,对儿童纵行黑甲的指导意义不明,尚需扩大样本量论证和长期随访。
Objective To analyze the clinical, dermoscopic and histopathologic features of longitudinal melanonychia with Hutchinson sign in children; and to explore and predict the property and management measures of longitudinal melanonychia in children.Methods A retrospective study of clinical, dermoscopic and histopathologic data of 32 pediatric patients of longitudinal melanonychia with Hutchinson sign, who were treated from June 2013 to June 2015 at Beijing Children＇s Hospital. Results The mean age was 4.5 years of 32 cases, and twenty-two patients were male and ten were female. The average duration of the lesion was 2.5 years. As for lesions locations, in 23 cases the melanonychia was located on a fingernail, with the thumb the most common site of occurrence（8 cases）, the remaining 9 appeared on the toenail, of which 4 cases were on the big toe. While lesions on Hutchinson sign＇s site, in 19 cases Hutchinson sign involved nail folds, in 10 cases it involved hyponychium, in 3 cases it involved both. Twenty cases exhibited melanocytic activation, 12 cases revealed nevi and 3 cases lentigines.22 had a pigmented band greater than 3mm.Nail plate dermoscopy demonstrated a regular brown lines on a brown background in 16 cases, a regular brown lines with globules on a brown background in 12 cases, a regular brown pattern in 3 cases, and a regular black pattern in 1 case. Onhistopathologic examination of lesions on nail matrix, 27 cases were categorized as nevi and 5 cases as lentigines. Conclusions Longitudinal melanonychia is typically associated with benign stable melanocytic proliferations in childhood. Biopsy or excision is required in select cases. Clinical data analysis and dermoscopy examination have a significant meaning on diagnosis and follow-up of childhood longitudinal melanon 4mm-wide Longitudinal melanonychia of the left thumb nail in an 4-year-boy; Nail plate dermoscopy shows regular brown lines and globules on a brown background with the Hutchinson＇s sign and distal nail dystrophy; a junctional nevus
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2016年第8期799-802,共4页
The Chinese Journal of Dermatovenereology
基金
北京市医院管理局临床医学发展专项经费资助(编号:ZYLX201601)
