| Objective: To aster the clinical characteristics of pigmented nevus,to explore the value of dermatoscope in the diagnosis of pigmented nevus,to explore the relationship between the characteristics of pigmented nevus and its pathological classification,and to improve the level of non traumatic diagnosis.Methods: This study was reviewed from October 2016 to January 2019,a total of 158 cases of pigmented nevus diagnosed by skin speculum before and after operation were diagnosed by pathological biopsy in dermatology department of our hospital.To analyze the clinical characteristics of the disease and to find out the pigmented nevus under the skin speculum by combining the features of sex,age,location,clinical manifestation,dermatological features and histopathological classification.The relationship between the characteristics and pathological classification.Results:158 cases of pigmented nevus were analyzed as follows:Sex ratio: 36 males(22.78%)and 122 females(77.22%).The ratio of men to women is0.30:1.Age Distribution: Pigmented nevus is most common in all age groups,with age distribution ranging from 9 to 74 years.With age increasing,the highest distribution is in the 30 to 39 age group(33.54%).Distribution: Pigmented nevus may occur in all parts of the body,and the head and face in 70 cases(44.30%).There were 50 cases of trunk(31.65%),14 cases of limbs(8.86%).And 24 cases of metacarpophalangeal region(15.19%).The skin lesions of junctional nevus are flat or slightly higher than the skin,and the color is mainly brown(55.56%),glabrous(100%).The skin lesions of the compound nevus were higher in appearance than those of the junctional nevus,round,brown or black,and had hair penetration(7.60%).Skin lesions of intradermal nevus are hemispherical papules or nodules with a smooth orpapilloma-like surface(34.81%),does not occur in the palmar toe.Pigmented nevi usually appear in 1-2 colors(96.84%)of black,brown,gray and blue in the skin mirror tone.Borderline nevus is usually dark brown(13.29%)under dermatoscope and pale brown(20.25%)under intradermal nevus(20.25%)under dermoscope.Borderline nevi are usually dark brown in color.The microscopic features of pigmented nevus were as follows: reticular pattern in 12cases(7.59%),compound nevus in 10 cases(6.37%)and intradermal nevus in 13cases(8.23%).Pigmented nevus is the most common skin specular pattern of pigmented nevus and the characteristic skin specular appearance of pigmented nevus.The globular pattern was seen in 18 cases(11.39%)of intradermal nevus and 17 cases(10.76%)of compound nevus,but not in the junctional nevus.Homogenous pattern was seen in 41 cases(25.95%)of intradermal nevus and 3 cases(1.90%)of compound benefit,but not in junctional nevus.The model of parallel dermoid groove was characteristic in 11 cases(6.96%)of palmoplantar pigmented nevus,and only found in the palmoplantar.Fiber pattern was seen in 2 cases(1.27%)of junctional nevus and1 case(0.63%)of compound nevus.In the two-component model,1 case(0.63%),6cases(3.80%)of compound nevus and 15 cases(9.49%)of intradermal nevus were found.Symmetrical multicomponent pattern was seen in 1 case of intradermal nevus(0.63%).The banding pattern was found in 1 case of inferior junctional nevus(0.63%).Exogenous pattern was seen in 6 cases(3.80%)of intradermal nevus.Eight of the 158 clinical cases were misdiagnosed as seborrheic keratosis 1case(0.63%),porokeratosis 1 case(0.63%),fibroma 2 cases(1.27%),hemangioma 2cases(1.27%),cyst 1 case(0.63%)and blue nevus 1 case(0.63%),with a total misdiagnosis rate of 5.06%.Conclusion:1.Pigmented nevus tends to occur at any age and increases with age.Clinical manifestations are varied and can occur anywhere on the body surface.2.Pigmented nevus usually appears in 1-2 colors of black,brown,gray and blue under dermoscopy.The junctional nevus is usually dark brown under dermoscopy.The intradermal nevus is usually pale brown in color under dermoscopy.3.Dermoscopic junctional nevus usually has reticular pattern,compound nevus usually has spherical pattern,and intradermal nevus usually has light brown homogeneous pattern.Parallel sulcus pattern is the characteristic manifestation of metacarpal and metatarsal nevus.4.Pathology is the gold standard for the diagnosis of pigmented nevus,and dermoscopy,as a non-invasive diagnostic method,can help improve the diagnostic accuracy,thus reducing unnecessary pathological biopsy and surgery. |
