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北京京煤集团总医院                                              第十届·2022 学术年会论文集


                            皮肤镜诊断脂溢性角化病的准确性及结果分析


                                    郭东东(北京京煤集团总医院皮肤科,北京  102300)

                   【摘要】目的:  探讨皮肤镜诊断脂溢性角化病的准确性,并与临床诊断、病理诊断结果相

                   比较,分析皮肤镜诊断脂溢性角化病的价值。方法:选取 2019 年 9 月~2020 年 9 月就诊于
                   北京京煤集团总医院,经组织病理检查和皮肤镜检查,诊断为脂溢性角化病的患者 61 例,

                   收集其临床和皮肤镜图像资料,进行回顾性分析,并与组织病理结果相比较,明确皮肤镜诊断

                   脂溢性角化病的价值,并分析脂溢性角化病的皮肤镜特征。结果:临床诊断正确率为 73.5%,

                   皮肤镜诊断正确率为 95.5%;皮肤镜特征主要表现为裂隙/脑回样外观(50.00%),粉刺样开

                   口(40.63%),点状/发夹样血管结构(20.31%),粟粒样囊肿(15.63%); 结论:皮肤镜可以

                   提高脂溢性角化病的诊断水平,为鉴别诊断提供重要依据。

                   【关键词】脂溢性角化病;皮肤镜;诊断水平;

                   Abstract:  Objective:To  study  the  accuracy  of  dermatoscopy  in  the  diagnosis  of  seborrheic

                   keratosis,  and  analyze  the  correlation  between  dermoscopic  and  pathological  of  Seborrheic

                   Keratosis; Methods Sixty-one patients with Seborrheic Keratosis diagnosed by histomathological

                   examination and dermoscopy, who were admitted to the Hospital of JINGMEI COPERATION from

                   September 2019 to September 2020, were selected to analyzed the value of dermoscopy in the

                   diagnosis of seborrheic keratosis, the characteristics of dermoscopy in seborrheic keratosis were
                   analyzed.  Results:  The  correct  rate  of  clinical  diagnosis  was  73.5%,  and  the  correct  rate  of

                   dermatoscopy was 95.5%.    The high frequency dermoscopy features of patients with seborrheic

                   keratosis  were  gully  like  structure(50.0%)  acne-like  opening(40.63%),  and  punctiform/hairpin

                   blood  vessels ( 20.31% ) ,  milia-like  cysts  was  next(15.63%).Conclusion:  Dermoscopy  can

                   significantly increase the diagnostic rate of seborrheic keratosis and provide an important basis for

                   differential diagnosis.

                   Key words : Seborrheic Keratosis; Dermoscopy; Diagnosis

                       脂溢性角化病(seborrheic keratosis, SK)亦称为老年疣(verruca senilis)、基底细胞乳头瘤

                   (basal cellpapilloma),是常见的上皮增生性皮肤良性肿瘤,极少癌变 。临床诊治过程中,
                                                                                   [1]
                   常依据其特征性表现进行临床诊断,但部分不典型和特殊类型的 SK 可以模仿恶性肿瘤造成

                   误诊,导致不必要的切除;一些恶性肿瘤(色素性基底细胞癌、黑色素瘤等)早期皮损或者

                                                                                      [2]
                   不典型皮损也可以模仿脂溢性角化病造成漏诊,导致忽视,造成不良后果 。皮肤镜被称为


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