Dermoscopic Features And Significance Of 329 Cases Of Single Lesion

Single skin lesion are very common in our clinical practice.They involve a wide range of diseases,including benign tumors,malignant tumors,inflammatory skin diseases,granulomatous diseases,infectious diseases,various damage and treatments being existed.There are many clinical manifestations of single skin lesion,with different diseases having the same manifestations and the same disease having different manifestations,so sometimes it is difficult to make the correct diagnosis according to the clinical manifestations only.It is very important to excavate the lesion information as much as possible to provide clues for correct diagnosis.As a noninvasive in vivo diagnostic technique,Dermatoscopy is currently gaining a higher status in the diagnosis of neoplastic diseases,infectious diseases,inflammatory diseases and skin appendage diseases.Objectives : The diagnostic value of dermatoscopy in single skin lesion was investigated by counting the dermoscopic features of different diseases and analyzing the consistency of dermoscopic diagnosis and pathological diagnosis.Secondly,it describes the dermoscopic features of rare diseases and provides experience for clinical practice.Methods: Retrospective analysis of 329 cases from December 2016 to August2018 was undertaken,including the sex,age,location,clinical manifestation,dermoscopic features and histopathological classification.Results:1.General data: this study enrolled 329 cases,male 118(35.87%),female 211(64.13%),the ratio of male to female was 0.56: 1.The age of the patients ranged from 6to 95 years old,with an average age of 52.73 years.There were 169 cases of single nodules in the head and face,accounting for 51.4%.The group of 40 years old and younger was mainly pigmented nevus,accounting for 80%(32/40).The group of 50 years old and older was mainly seborrheic keratosis and Actinic keratosis,basal cell carcinoma,squamous cell carcinoma,Bowen’s disease,of which malignant and precancerous lesions accounted for 54.3%(63/116).2.Dermoscopy results82 cases of pigmented nevus,and 77 cases were correctly diagnosed by dermoscopy,the coincidence rate being 93.9%.5 cases of malignant melanoma,and 5 cases were correctly diagnosed by dermoscopy,the coincidence rate being 100%.93 cases of seborrheic keratosis,and 84 cases were correctly diagnosed by dermoscopy,the coincidence rate being 90.3%.27 cases of basal cell carcinoma,and 25 cases were correctly diagnosed by dermoscopy,the coincidence rate being 92.6%.25 cases of actinic keratosis,and 19 cases were correctly diagnosed by dermoscopy,the coincidence rate being 76%.8 cases of Bowen’s disease,and 5 cases were correctly diagnosed by dermoscopy,the coincidence rate being 62.5%.7 cases of keratoacanthoma,and 5 cases were correctly diagnosed by dermoscopy,the coincidence rate being 71.4%.8 cases of squamous cell carcinoma,and 5 cases were correctly diagnosed by dermoscopy,the coincidence rate being 62.5%.13 cases of cutaneous fibroma,and 12 cases were correctly diagnosed by dermoscopy,the coincidence rate being 85.7%.5 cases of lichen planus,all the cases were correctly diagnosed by dermoscopy,the coincidence rate being 100%.10 cases of lichen planus keratosis,5 cases were correctly diagnosed by dermoscopy,the coincidence rate being 50%.7 cases of granulomatous inflammation and 2 cases were correctly diagnosed by dermoscopy,the coincidence rate being 28.6%.7 cases of epidermal cysts,and 6 cases were correctly diagnosed by dermoscopy,the coincidence rate being 85.7%.5 cases of verruca vulgaris and 3 cases were correctly diagnosed by dermoscopy,the coincidence rate being 60%.The presentations of hemangioma,comedo nevus,sebaceous nevus,scars,Bowenoid papulosis under dermoscopy.4.Dermoscopic features of rare diseasespyogenic granuloma: a case presented with reddish homogeneous are,white collarette,ulcers and white rail lines under dermoscopy.Another case showed blue homogeneous area under dermoscopy.Dermatofibrosarcoma protuberans: pinkish background,fine pigmented networks,vascular structures,and hypopigmentation areas under dermoscopy.Nevus epidermis: brown background and a blue-white area in the middle of the lesion under dermoscopy.Hemangiosarcoma: the blue-purple areas and the white line under dermoscopy.Poroma: lacunar structure surrounded by pink-white halo and ulcers under dermoscopy.Conclusions:1.Dermoscopic coincidence rates of MM(100%),LP(100%),pigmented nevus(93.9%),BCC(92.6%),SK(90.3%),DF(85.7%)and epidermal cyst(85.7%)were higher.Dermoscope was the first choice for assistant diagnosis.AK(76%),KA(71.4%),Bowen’s disease(62.5%),SCC(62.5%),verruca vulgaris(60%)and LPLK(50%)have a general coincidence rate with dermoscopy,and dermoscopy can be determined according to specific conditions.Granulomatous inflammation(28.6%)had a low coincidence rate with dermoscopy and could not rely too much on dermoscopy.2.The dermoscopic manifestations of rare diseases such as suppurative granuloma,protuberant dermatofibrosarcoma,epidermal nevus and angiosarcoma have certain characteristics.Dermoscopy can provide a reference for diagnosis.