| Objective:Facial hormone dependence dermatitis(HDD), seborrheic dermatitis(SD), rosacea and contact dermatitis are common facial inflammatory diseases.When clinical manifestations are not typical,it often causes trouble for clinical doctors to diagnose and treat the diseases.The value of dermoscopy in the diagnosis of tumorous lesions has been fully affirmed.In recent years, more and more inflammatory skin diseases are observed in dermoscopy for their diagnoses and treatments.While research on dermoscopic characteristics of common facial inflammatory dermatoses is less.This paper aims to summarize the characteristics of common facial inflammat--ory dermatoses in dermoscopy and look for its relative specific features to help clinician's diagnoses and treatments.Methods:We collected a total of 151 cases of patients with facial inflammatory skin diseases from September 2015 to January 2016 in department of dermatology,Affiliat--ed hospital of tianjin academy of traditional Chinese medicine.Patients with HDD,SD, rosacea and contact dermatitis are 47,39,34,31,respectively.We recorded patients' genders, ages, lesion locations, clinical manifestations and signs in detail.And we collected dermoscopic images and analyzed characteristics of common facial inflammatory dermatoses in dermoscopy,including background color, vascular morphology,vascular arrangement and hair follicle abnormalities.We are looking for relative specific features to explore the feasibility of dermoscopy in distinguishing different common facial inflammatory skin diseases.All the analyses were performed using SPSS 17.0 software.For all dermoscopic variables chi-square test was performed in order to compare their incidence between different groups. Significance level was set at 0.05. Sensitivity, specificity, positive and negative prognostic value were calculated for each dermoscopic criterion.Results: 1.47 HDD lesions exhibited a dermoscopic pattern consisting of red(24,51.06%)or dull red(16,34.04%) background,polymorphic vessels(31,65.96%) or arborizing vessels(28,59.57%), irregular(32,68.09%) or reticular arrangement(12,25.53%).For the diagnosis of HDD, arborizing vessels shows the highest sensitivity and specificity,59.57% and 92.31%, respectively. 2. 39 Facial SD lessions exhibited a dermoscopic pattern consisting of yellowish-red(21,53.85%)or red(11,28.21%) background,polymorphic vessels(27,69.23%)or dotted vessels(15,38.46%), irregular(26,66.67%) or clustered(13,33.33%)arrangement,the specificity for SD were 93.62%,48.94%,34.04%,72.34%,31.91% and 93.62%,repectively.Perifollicular halo was relative specific for SD,the specificity for SD was 80.85%. 3.The most significant dermoscopic features of 34 facial rosacea lesions were red(17,50.00%)or dull red(14,41.18%) background,polygonal(12,35.29%) or arborizing vessels(16,47.06%)and reticular arrangement(21,61.76%).The specificity for rosacea were 64.52%,90.32%,100.00%,74.19% and 96.77 %, respect--ively. 4.31 Facial contact dermatitis lessions were characterized by reddish(13,41.94%) or red background(11,35.48%),dotted vessels(20,64.52%) or polymorphic vessels(12,38.71%) and irregular arrangement(24,77.42%)in dermoscopy.The specificity for contact dermatitis were 100.00%,50.00%,73.53%,64.71% and 70.59%, respectively. 5.Under polarized dermoscopy,we observed the rosette structure(Patients with HDD, SD,rosacea and contact dermatitis are 2,4,1,3,respectively) and fiber grid structure(Patients with HDD,SD,rosacea and contact dermatitis are 6, 9,5,3,respectively) in all four common facial inflammatory diseases.All of these findings were not metioned in previous articles.We believed that rosettes are probably attributable to an optical effect of the polarized light and its interaction with adnexal openings that are either narrowed or filled with keratin,inflammatory cell infiltration and scales.While fiber grid structures are formed by inflammatory substances and keratinocytes.Both of the--m are not specific for diagnosis of these four different diseases. Conclusions: 1.Facial HDD, SD, rosacea and contact dermatitis showed different characteristics in dermoscopy,thus these features can be used for clinical diagnosis. 2.The rosette structure and fiber grid structure are dermoscopic features which can be observed under polarized dermoscopy.Both of them are not specific for the diagnosis of dermatitis. |
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