The Characteristics And Clinical Significance Of Dermoscopy And Reflectance Confocal Microscopy In Children With Hypopigm Ented Diseases

Objective: 1)To compare and analysis the characteristic of childhood hypopigmentation disorders' images in dermoscopy and RCM;2)To explore the clinical significance of dermoscopy and RCM in children with hypopigmentation disorders.Methods: 300 cases of children with hypopigmention disorders were enrolled in our study,including 67 cases of vitiligo,120 cases of amelanotic nevus,57 cases of pityriasia alba,33 cases of postinflammatory hypomelanosis,19 cases of tinea versicolor,2 cases of naevus anemicus and 2 cases of piebaldism,and all the changes of the characteristic images of various hypopigmentation disorders were observed and analyzed by means of dermoscopy and RCM.And exploring the clinical value of the diagnosis and differential diagnosis of childhood vitiligo with dermoscopy and RCM by statistical analysis.Results: 1.67 cases of vitiligo lesions exhibited a dermosopic pattens involving milky white background(42,62.69%),pigment island(6,8.96%),perifollicular pigmentation(35,52.24%),marginal hyperpigmentation(17,25.37%),while the RCM patterns consisted of partial absence of the pigment cells(32,53.73%)or complete absence of the pigment cells(20,29.85%),infiltration of inflammatory cells in the superficial dermis(29,43.28%)and melanophges(27,40.30%).2.120 cases of vitiligo lesions nevus depigmentosus exhibited a dermosopic pattens involving light white background(106,90%),dotted blood vessels(84,70%),linear blood vessels(91,75.83%),while the RCM patterns consisted of slightly decreased pigment in the basal layer(111,92.50%)or obviously complete decreased pigment in the basal layer(7,5.83%).3.57 cases of pityriasis alba lesions exhibited a dermosopic pattens consisted of light white background(49,85.96%),linear blood vessels(91,75.83%),white scales(38,66.67%),while the RCM patterns consisted of slightly decreased pigment in the basal layer(52,91.23%),infiltration of inflammatory cells in the superficial dermis(39,68.42%).4.19 cases of tinea versicolor lesions exhibited a dermosopic pattens involving pale white background(17,89.47%),linear blood vessels(10,52.63%),white scales(17,89.47%),while the RCM patterns consisted of slightly decreased pigment in the basal layer(19,100%),and mycelium in the horny layer is specific manifestation of versicolor lesions.5.33 cases of postinflammatory hypomelanosis lesions exhibited a dermosopic pattens involving light white background(28,84.85%)?dotted blood vessels(18,54.55%),linear blood vessels(21,63.64%),while the RCM patterns consisted of slightly decreased pigment in the basal layer(32,96.97%).6.The absence of pigment cells in RCM is the specific feature of vitiligo.And taking the absence of pigment cells with RCM as the criteria for quality control,the sensitivity and specificity of milk white background and perifollicular pigmentation with dermoscopy are relatively high,which are respectively 67.3%,93.5% and 54.5%,92.7%.Conclusion: 1.Dermoscopy and RCM can be used as means for the diagnosis and differential diagnosis of the childhood vitiligo and other skin hypopigmentation diseases.2.The accuracy of RCM in the diagnosis of childhood vitiligo is higher than that of dermoscopy.