皮肤镜在尖锐湿疣诊断及鉴别诊断中的应用
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摘要
目的探讨皮肤镜在尖锐湿疣诊断及鉴别诊断中的应用价值。方法对疑似尖锐湿疣的136个皮损分别进行医生肉眼判断、皮肤镜检查、组织病理诊断,以组织病理为诊断金标准,并对前两种诊断方法进行统计学检验。结果医生临床肉眼判断的敏感性为94. 26%,特异性为35. 71%,准确性为88. 24%;皮肤镜检查的敏感性为96. 72%,特异性为85. 71%,准确性为95. 59%。两组方法判断结果的敏感性差异无统计学意义(P> 0. 05),特异性差异有统计学意义(Fisher精确概率法:P=0. 018),准确性差异亦有统计学意义(P <0. 05)。结论皮肤镜在尖锐湿疣诊断及鉴别诊断中敏感性同临床肉眼判断,特异性及准确性优于前者,无创、耗时、花费优于组织病理。
Objective To evaluate the application value of dermatoscopy in the diagnosis and differential diagnosis of condyloma acuminatum. Methods One hundred and thirtysix lesions of patients with suspected condyloma acuminatum were diagnosed by naked eye judgement,dermoscopy and histopathology. The histopathology was taken as the standard. The first two diagnostic methods were tested by statistics. Results The sensitivity,specificity and accuracy of clinical naked eye judgement were 94. 26%,35. 71% and 88. 24% respectively. The sensitivity,specificity and accuracy of dermoscopy were 96. 72%,85. 71% and 95. 59%,respectively. There was no significant difference in sensitivity( P > 0. 05). The specificity had statistical significance( Fisher' s exactprobabilities test: P = 0. 018),and the accuracy had statistical significance( P < 0. 05). Conclusion The sensitivity of dermoscopy in the diagnosis and differential diagnosis of condyloma acuminatum is similar to that of clinical naked eye,and its specificity and accuracy are better than the former. Its noninvasive,time-consuming features and cost were superior to histopathology.
Objective To evaluate the application value of dermatoscopy in the diagnosis and differential diagnosis of condyloma acuminatum. Methods One hundred and thirtysix lesions of patients with suspected condyloma acuminatum were diagnosed by naked eye judgement,dermoscopy and histopathology. The histopathology was taken as the standard. The first two diagnostic methods were tested by statistics. Results The sensitivity,specificity and accuracy of clinical naked eye judgement were 94. 26%,35. 71% and 88. 24% respectively. The sensitivity,specificity and accuracy of dermoscopy were 96. 72%,85. 71% and 95. 59%,respectively. There was no significant difference in sensitivity( P > 0. 05). The specificity had statistical significance( Fisher' s exactprobabilities test: P = 0. 018),and the accuracy had statistical significance( P < 0. 05). Conclusion The sensitivity of dermoscopy in the diagnosis and differential diagnosis of condyloma acuminatum is similar to that of clinical naked eye,and its specificity and accuracy are better than the former. Its noninvasive,time-consuming features and cost were superior to histopathology.
引文
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[4]崔勇,林艳,于瑞星,等.历史、现状和发展方略---皮肤镜在中国[J].中国皮肤性病学杂志,2017,31(2):119-122.
[5]李倩男,孔祥军,刘媛媛,等.皮肤镜在特殊部位皮肤病中的应用进展[J].中国皮肤性病学杂志,2017,31(3):330-331.
[6]Dong H,Shu D,Campbell TM,et al.Dermatoscopy of genital warts[J].J Am Acad Dermatol,2011,64(5):859-864.
[7]中华医学会皮肤性病学分会性病学组,中国医师协会皮肤科分会性病亚专业委员会.尖锐湿疣诊疗指南(2014)[J].中华皮肤科杂志,2014,47(8):598-599
[8]金可,孔祥军,周璟,等.传染性软疣61例患者皮损的皮肤镜下特征分析[J].中国皮肤性病学杂志,2015,29(11):1137-1138.
[9]Marcucci C,Sabban EC,Friedman P,et al.Dermoscopic findings in bowenoid papulosis:report of two cases[J].Dermatol Pract Concept,2014,4(4):61-63.
[10]吴剑波,郑家润.皮肤镜技术的基础与临床应用[J].国际皮肤性病学杂志,2005,31(5):282-284.
[11]Zalaudek I,Lallas A,Moscarella E,et al.The dermatologist's stethoscope-traditional and new application of dermoscopy[J].Dermatol Pract Cone,2013,3(2):11.
[12]党延玲,刘亚乐,曾维惠,等.皮肤镜在铒玻璃点阵激光治疗痤疮疗效观察中的应用[J].中国皮肤性病学杂志,2017,31(5):508-510.
[2]Marghoob AA,Malvehy J,Braun RP.徐峰,周城主译.皮肤镜图谱[M].上海:复旦大学出版社,2016:1-256.
[3]杨欣融,袁定芬,孙睿,等.皮肤镜在黑素细胞肿瘤诊断中的应用[J].临床皮肤科杂志,2015,44(11):756-760.
[4]崔勇,林艳,于瑞星,等.历史、现状和发展方略---皮肤镜在中国[J].中国皮肤性病学杂志,2017,31(2):119-122.
[5]李倩男,孔祥军,刘媛媛,等.皮肤镜在特殊部位皮肤病中的应用进展[J].中国皮肤性病学杂志,2017,31(3):330-331.
[6]Dong H,Shu D,Campbell TM,et al.Dermatoscopy of genital warts[J].J Am Acad Dermatol,2011,64(5):859-864.
[7]中华医学会皮肤性病学分会性病学组,中国医师协会皮肤科分会性病亚专业委员会.尖锐湿疣诊疗指南(2014)[J].中华皮肤科杂志,2014,47(8):598-599
[8]金可,孔祥军,周璟,等.传染性软疣61例患者皮损的皮肤镜下特征分析[J].中国皮肤性病学杂志,2015,29(11):1137-1138.
[9]Marcucci C,Sabban EC,Friedman P,et al.Dermoscopic findings in bowenoid papulosis:report of two cases[J].Dermatol Pract Concept,2014,4(4):61-63.
[10]吴剑波,郑家润.皮肤镜技术的基础与临床应用[J].国际皮肤性病学杂志,2005,31(5):282-284.
[11]Zalaudek I,Lallas A,Moscarella E,et al.The dermatologist's stethoscope-traditional and new application of dermoscopy[J].Dermatol Pract Cone,2013,3(2):11.
[12]党延玲,刘亚乐,曾维惠,等.皮肤镜在铒玻璃点阵激光治疗痤疮疗效观察中的应用[J].中国皮肤性病学杂志,2017,31(5):508-510.