[1]韩晓锋,张立新,周春菊,等.儿童Hutchinson氏征阳性纵行黑甲32例临床分析[J].中国皮肤性病学杂志,2016,(08):799-802.[doi:10.13735/j.cjdv.1001-7089.201603071]
 HAN Xiao-feng,ZHANG Li-xin,ZHOU Chun-ju,et al.Clinical, Dermoscopic and Histopathologic Analysis of 32 Cases of Longitudinal Melanonychia with Hutchinson Sign in Children[J].The Chinese Journal of Dermatovenereology,2016,(08):799-802.[doi:10.13735/j.cjdv.1001-7089.201603071]
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儿童Hutchinson氏征阳性纵行黑甲32例临床分析
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《中国皮肤性病学杂志》[ISSN:1001-7089/CN:61-1197/R]

卷:
期数:
2016年08期
页码:
799-802
栏目:
临床经验
出版日期:
2016-08-01

文章信息/Info

Title:
Clinical, Dermoscopic and Histopathologic Analysis of 32 Cases of Longitudinal Melanonychia with Hutchinson Sign in Children
作者:
韩晓锋张立新周春菊徐教生徐子刚马琳
首都医科大学附属北京儿童医院皮肤科,北京100045
Author(s):
HAN Xiao-fengZHANG Li-xinZHOU Chun-juXU Jiao-shengXU Zi-gangMA Lin
Department of Dermatology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
关键词:
儿童 纵行黑甲 甲母痣 Hutchinson氏征 皮肤镜
Keywords:
Children Longitudinal melanonychia Hutchinson sign Dermoscopy
分类号:
R 758.72
DOI:
10.13735/j.cjdv.1001-7089.201603071
文献标志码:
B
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。
Abstract:
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 in the lesion of nail matrix; acompound nevus in Hutchinson's sign of nail fold Clinical, dermoscopic and histopathologic data of the patient with the Hutchinson's sign in nail fold(HE×200)ychia; there is no evidence that Hutchinson sign, which is suggestive of malignancy risk in adult longitudinal melanonychia, has significance to instruct the diagnosis of childhood longitudinal melanonychia. We need to further expend sample size and long-term follow-up all the patients.

参考文献/References:

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备注/Memo

备注/Memo:
[基金项目] 北京市医院管理局临床医学发展专项经费资助(编号:ZYLX201601)
更新日期/Last Update: 2016-08-10