| Objective:Utilizing the retrospective analysis for 1316 anevocytic nevus skin damage syndrome patients to investigate the relationship between clinical and pathology,conclude the clinical characters for further improve the Diagnosis and treatment level of clinicist for this disease.Methods:Collected 1316 patients who were diagnosed with nevocytic nevus skin damage syndrome and Pathological examination after surgical resection in the Dermatology of Dalian Medical University second affiliated hospital during from 2015 to 2016.Registered the General information before the surgery,record the clinical manifestation,take photos for Surgical site and archives,then send to pathologic examination after surgical removal.Analysis the age,sex,analysis the reported and proportion according to the pathological diagnosis.Analysis the area of all patients which be divided into four groups,the face & neck care,the trunk care,the limb care,the hand & foot care(the trunk group does not include the genitals,the group of hand & foot does not include the fingernail).According to the results of pathological diagnosis,all the selected cases were divided into three groups including junctional nevus,intradermal nevus and compound nevus.Analysis the histopathological typing of different group.Analysis the reported and proportion according to the pathological diagnosis.Statistics analyze all cases of pathological diagnosis different from clinical diagnosis,and calculate the missed diagnosis and misdiagnosis according to the disease.All of the patients were diagnosed and Collected samples by Senior title of professional physicians,the pathological slices were made by Professional technicians,histopathologic slice was read by the senior pathologist professor and ruled out thesamples which the clinical records is not complete.After the clinical data and pathological classification statistics,SPSS software was used to treat with the data,measurement data was analyzed by variance analysis,rate comparison was analyzed by chi-square test,P<0.05 was statistically significant.Results:Ⅰ.1092 cases of 1316 patients were confirmed with pigmented nevus by histopathological diagnosis(83.0%),seborrheic keratosis in 136 cases(10.3%),Blue nevus in 15 cases(1.2%),fibroma in 14 cases(1.1%),sebaceous hyperplasia in 7 cases(0.5%),Basal cell carcinoma in 6 case(0.5%).Warts in 5 cases(0.4%),the others like sebaceous cyst,hemangioma,solar keratosis edl.in 41 case(3.1%).Ⅱ.Patient’s age distribution from 2 to 87,the average age was 34.5±14.0,most patients were at the age of 30 to 49.Pathology results showed that Patients confirmed by pigmented nevus were at younger age,mainly at the aged of 20-39,,Seborrheic keratosis always found in older patients,mainly at the aged of 40-79,Blue nevus age are mainly concentrated in patients with aged 20 to 59,dermatofibroma patients age mainly concentrated in the aged 20 to 59,basal cell carcinoma patients mainly concentrated in the ages of 40 and 79 years of age.Warts patients age distribution on the average.Ⅲ.Male patients in 402 cases,female patients in 914 cases,the rate of male and female was 1:2.27.Ⅳ.Pigmented nevus patients in 1092 cases,the face & neck care in 676 cases(61.9%),the trunk care in 228 cases(20.9%),the limb care in 64 cases(5.9%),the hand & foot care in 124 cases(11.3%).In the face & neck care,,junctional nevus in 30cases(4.5%),intradermal nevus in 587 cases(86.8%)and compound nevus in 59cases(8.7%).In the trunk,junctional nevus in 25 cases(11.0%),intradermal nevus in186 cases(81.6%)and compound nevus in 17 cases(7.4%).In the limb,junctional nevus in 19 cases(29.7%),intradermal nevus in 35 cases(54.7%)and compound nevus in 10 cases(15.6%).In the hands and feet,junctional nevus in 102 cases(82.3%),intradermal nevus in 16 cases(12.9%)and compound nevus in 6 cases(4.8%).Ⅴ.1045 cases of Pathologic results conformed the clinical diagnosis,while 271 cases were not,the total conforming rate of diagnose was 79.4% Among to it,224 cases misdiagnosed as pigment nevus,47 cases misdiagnosed as other diseases.The misdiagnosis rate was 17.7%,the missed diagnosis rate was 4.3%Conclusion:Ⅰ.The clinical diagnosis of pigmented nevus most easily misdiagnosed for these disease: Seborrheic keratosis,blue nevus and skin fibroma.Ⅱ.The reason of misdiagnosis of pigmented nevus is mainly recognition to the naked eye to the color and form of skin and the differences of individual skin manifestations.Ⅲ.Nevus density was highest on the face & neck care.Nevus was most likely canceration on the hand & foot care.Ⅳ.In the diagnosis of pigmented skin lesions,it is very important to distinguish the malignant lesions.Ⅴ.The pathological diagnosis of pigmented nevus is the gold standard of diagnosis,clinical diagnosis should be combined with pathological diagnosis. |
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