多发性晕痣1例

患儿男,15岁.因全身多处黑色丘疹周围出现圆形白斑1年余,于2010年8月4日来我科门诊就诊.1年前患儿背部一色素痣周围出现圆形白斑,白斑以色素痣为中心逐渐增大,随后背部、胸肩部和面部多个色素痣周围出现类似的圆形白斑.局部无痛、痒等不适,亦无破溃、渗出等表现.既往体健.无手术外伤史及药物过敏史.家族中无白癜风病史及黑素瘤病史.体格检查:系统检查未见异常.     

黄褐斑和白癜风的诊疗标准(2010年版)

一、白癜风 (一)诊断标准:①通常在儿童期或青年期发病,表现为大小和形状各异的脱色性白斑,周围颜色正常或有色素增加.②皮损好发于面部、颈部、手背和躯干;腔口黏膜及周围皮肤也易受侵犯,如眼、鼻、口、耳、乳头、脐、阴茎、女阴和肛门;亦常见于外伤部位;白斑部位的毛发通常也变白.③排除炎症后色素减退斑、斑驳病、特发性色素减退斑、白色糠疹、无色素痣和贫血痣等皮肤病.④或者Wood灯下白斑区见亮白色荧光.     

黄褐斑和白癜风的诊疗标准(2010年版)

一、白癜风 (一)诊断标准:①通常在儿童期或青年期发病,表现为大小和形状各异的脱色性白斑,周围颜色正常或有色素增加.②皮损好发于面部、颈部、手背和躯干;腔口黏膜及周围皮肤也易受侵犯,如眼、鼻、口、耳、乳头、脐、阴茎、女阴和肛门;亦常见于外伤部位;白斑部位的毛发通常也变白.③排除炎症后色素减退斑、斑驳病、特发性色素减退斑、白色糠疹、无色素痣和贫血痣等皮肤病.④或者Wood灯下白斑区见亮白色荧光.     

黄褐斑和白癜风的诊疗标准(2010年版)

一、白癜风 (一)诊断标准:①通常在儿童期或青年期发病,表现为大小和形状各异的脱色性白斑,周围颜色正常或有色素增加.②皮损好发于面部、颈部、手背和躯干;腔口黏膜及周围皮肤也易受侵犯,如眼、鼻、口、耳、乳头、脐、阴茎、女阴和肛门;亦常见于外伤部位;白斑部位的毛发通常也变白.③排除炎症后色素减退斑、斑驳病、特发性色素减退斑、白色糠疹、无色素痣和贫血痣等皮肤病.④或者Wood灯下白斑区见亮白色荧光.     

先天性色素痣术后诱发白癜风及多发性晕痣一例

先天性色痣（Congenital Pigmented Nevus）是一种特殊类型的痣细胞痣,约有10%的恶变倾向[1]。临床上为预防恶性变,常切除巨大色素痣。现将1例患者先天性色痣切除后诱发白癜风及多发性晕痣报告如下。     

几种色素减退性皮肤病的共聚焦激光扫描显微镜图像特点

目的 观察白癜风、无色素痣、进行性斑状色素减少症、贫血痣的活体共聚焦激光扫描显微镜（CLSM）特征。方法 用CLSM观察同一层面（基底层真表皮交界处）皮损处、交界处及白斑周边正常皮肤的镜下特征。结果 进展期白癜风白斑区部分区域色素完全缺失,部分区域可见残存色素环,残存之色素环结构欠完整且色素含量降低;交界处界限模糊;白斑周边正常皮肤可见部分色素环失去完整性。稳定期白癜风白斑处色素完全消失;交界处界限清晰;白斑周边正常皮肤色素环完整,折光明亮;恢复期可见到树突状、折光明亮的黑素细胞。无色素痣和进行性斑状色素减少症的CLSM表现相似：白斑处色素环结构完整,色素含量降低,折光减弱。贫血痣白斑处色素环结构和色素含量与周边正常皮肤无明显差异。结论 结合临床表现,CLSM可以作为鉴别诊断白癜风、无色素痣、进行性斑状色素减少症、贫血痣的一种辅助方法。     

皮肤镜对常见色素减退性疾病的临床图像特征分析技术的建立

目的:建立皮肤镜对白癜风、白色糠疹、无色素痣、炎症后色素减少症、进行性斑状色素减少症、老年性白斑和贫血痣的临床图像特征分析技术。方法:分别观察1439例色素减退性疾病患者的皮损,用皮肤镜观察肉眼不可见的细微结构,如背景颜色、血管形态、边界情况、毛发及毛囊是否异常等。应用卡方检验和Fisher精确检验方法进行统计学分析。结果:瓷白色、花斑色和浅白色背景色度分别为白癜风稳定期、无色素痣和进行性斑状色素减少症的较特异性皮肤镜图像特征。灰白色糠状鳞屑是白色糠疹的特异性皮肤镜图像特征,可区别于其他疾病。进展期白癜风特征为乳白色背景,边界模糊,毛囊周围色素残留,周边点状、不规则状色素减退斑,斑片状色素残留。稳定期白癜风特征为瓷白色背景,边界清晰,毛囊周围色素残留,皮损周围色素加深。恢复期白癜风特征为边界清晰,毛囊周围色素残留,皮损周围色素加深,易见色素岛。白色糠疹特征为淡黄白色背景,表面细小或片状灰白色糠状鳞屑,边界模糊。无色素痣:花斑样背景,边界模糊,斑片状色素残留。炎症后色素减少症特征为黄白色背景,边界模糊。进行性斑片状色素减少症特征为浅白色背景,边界模糊。老年性白斑特征为乳白色背景,边界清晰。贫血痣特征为黄白色背景,边界模糊,摩擦后周边呈现网格状血管分布。结论:皮肤镜临床图像特征分析技术可作为诊断和鉴别诊断白癜风、白色糠疹、无色素痣、炎症后色素减少症、进行性斑状色素减少症、老年性白斑和贫血痣的一种辅助方法。     

巨大晕痣1例

<正>1临床资料患儿男,9岁。右臀部白斑3个月。患儿出生时即发现右臀部有花生米大黑斑,边界清楚,随年龄增长逐渐增大,有较粗的毛发,无自觉症状,就诊于多家医院均诊断为先天性色素痣。3个月前无明显诱因,于色素痣周围出现白斑,同时色素痣颜色逐渐变淡,部分毛发变白,无自觉症状。患儿足月顺产,父母非近亲结婚,既往健康,家族成员中无先天性色素痣及白癜风病史。体检:各系统检查未见异常。皮肤科情况:右臀部一约6.0     

巨大先天性色素痣皮损处出现白毛1例

报告巨大先天性色素痣皮损处出现白毛1例。患者男，34岁。患巨大先天性色素痣34年。2年前发现胸部色素痣上部分胸毛变白，患者无白瘢风、晕痣及皮肤色素减退。先天性巨大色素痣上出现白毛值得研究。     

巨大晕痣1例

1 临床资料患者男,16岁.腰部皮损15年.患儿1岁时其母亲发现腰部出现一黄豆大色素痣,其周围绕以一卵圆形白斑,随着年龄增长,色素痣及白斑逐渐扩大,无不适.未予任何处理.后因虑其恶变至本科就诊.既往体健,家族中无类似疾病,亦无白癜风病史.体检:发育和智力正常,系统检查未见异常.皮肤科情况:腰部可见一3.0cm×6.0cm大椭圆形色素痣,隆起,表面凹凸不平,呈颗粒状,针帽至米粒大小,光滑,无毛,边缘颜色较淡,周围绕以约16.0cm×16.0cm的卵圆形色素脱失斑,界清(图1).在局部浸润麻醉下,沿色素痣的纵轴方向,梭形切口完全切除色素痣,至皮下组织.皮损组织病理示:痣细胞排列成实体团块,条索、巢状结构,分布于表皮内(图2);痣细胞呈圆形、梭形、多边形,轮廓清楚,胞浆丰富,核圆形、空泡状,可见明显黑色素(图3).病理诊断:混合痣.诊断:巨大晕痣.术后第9天拆线,切口甲级愈合.术后第3个月及第6个月随访,见切口形成疤痕,周围色素脱失斑无减退或消失.     

Association of giant congenital melanocytic nevus, halo nevus and vitiligo in a 75-year-old patient

A giant congenital melanocytic nevus represents a rare condition. The halo phenomenon may be seen in congenital or acquired melanocytic nevi. In the literature, association of halo nevus and giant congenital melanocytic nevus is rare and the association of both with vitiligo even more rare. A 75-yearold woman at first consultation complained of a hyperchromic bluish-brown hairy macula on the lower back, buttocks and thighs present since birth and an achromic halo of onset three years ago. The histological features were consistent with congenital melanocytic nevus and halo nevus, respectively. After two years the patient developed achromic areas in normal skin, histologically consistent with vitiligo. The authors emphasize the rarity of this triple combination, the patient's age and the absence of malignant degeneration to date.     

Resolution of vitiligo following excision of halo congenital melanocytic nevus: a rare case report

Halo congenital melanocytic nevus (CMN) associated with vitiligo is rare, especially with regard to CMN excision. Only two reports of excision of halo CMN following repigmentation of vitiligo are found in the literature. We present a case of a girl with halo CMN and periorbital vitiligo. The halo CMN was excised and followed by spontaneous improvement of vitiligo. The result suggests excision of the inciting lesion may be a promising way to control vitiligo.     

Resolution and Recurrence of Vitiligo Following Excision of Congenital Melanocytic Nevus

Abstract: Vitiligo associated with halo congenital melanocytic nevus (CMN) is rare. There are limited reports in the literature, especially with regard to CMN excision. We present the case of a 5‐year‐old girl who presented with vitiligo of the periorbital and axillary regions and halo formation around CMN of the buttock. The lesion was excised, and all areas of vitiligo improved, but 18 months postoperatively, a halo of depigmentation appeared around the excision scar and later in the periorbital and axillary regions. In review of literature, there is only one report of excision of halo CMN and resultant improvement of vitiligo. Although initial resolution of vitiligo in this case was promising, the recurrence indicates that this complex process is not reliably controlled with excision of the inciting lesion.     

Periocular vitiligo with onset around a congenital divided nevus of the eyelid

Leukoderma in association with congenital melanocytic nevi is a rare phenomenon; nevertheless several reports have been published in the literature. We present a 15-year-old boy born with a pigmented lesion on the lower and upper eyelid diagnosed as a congenital divided nevus of the eyelid. At the age of 13, he developed a depigmented area around the nevus and was diagnosed at first as having a halo nevus in a congenital nevus. Over the next two years, an area of depigmentation appeared around the contralateral eye. At the present time, the patient has bilateral periocular depigmentation. Congenital divided nevus of the eyelid is a rare lesion, and no reports have been published to date of depigmentation in association with this lesion. Our patient presented with depigmentation around the nevus as in a halo nevus phenomenon, although at the present time, the depigmented area has a symmetric periocular distribution, and therefore can be labeled as periocular vitiligo associated with a congenital divided nevus.     

Origin of cutaneous melanoma in a congenital dysplastic nevus spilus

Cutaneous melanoma developed in contiguity with a congenital nevus spilus on the leg of a 79-year-old white woman. The unique features of the nevus spilus in this case were its relatively large size (diameter, 8 cm), irregular gross appearance, lifelong stability until the recent appearance of a tumor nodule, and the presence of intraepidermal melanocytic dysplasia appearing as multifocal elements within darkly pigmented speckles distributed throughout a lightly pigmented background of lentigo simplex. Based on this observation, we suggest that the presence of intraepidermal melanocytic dysplasia in nevus spilus may be a predisposing factor for the development of melanoma. The malignant potential of "dysplastic" nevus spilus requires further study.     

Prepubertal Melanoma Arising within a Medium‐Sized Congenital Melanocytic Nevus

We report the case of an 8‐year‐old child who developed a 9.4‐mm‐deep melanoma within a medium‐sized congenital melanocytic nevus on the scalp. Genetic analysis revealed an activating NRAS Q61R mutation within the melanoma, which is more commonly associated with large or giant congenital melanocytic nevi. This case demonstrates that even a “low‐risk” congenital melanocytic nevus at a “low‐risk” age must be monitored regularly for the development of malignancy.     

Desmoplastic hypopigmented hairless nevus: a variant with progressive depigmentation, induration, and overgrowth

Large congenital melanocytic nevus rarely presents itself without hairs, with hardened skin and progressive depigmentation. We report a girl who presented with a large congenital melanocytic nevus in the left cheek. Over the years, the nevus became pruriginous, light brown, bumpy, and hard. Histology revealed nevus cells interspersed with dense fibrosclerotic collagen bundles. There are few reported cases of large congenital melanocytic nevus with this evolution, so-called desmoplastic hypopigmented hairless nevus.     

Neurotized Congenital Melanocytic Nevus Resembling a Pigmented Neurofibroma

Neurotized congenital melanocytic nevus and pigmented neurofibroma (PNF) are close mimics and pose a clinicopathological challenge. We present a case of pigmented hypertrichotic plaque over lumbosacral region and discuss the differential diagnosis and its clinical, histopathological and immunohistochemistry features which may aid in differentiation. We highlight the difficulties faced in differentiating neurotized congenital melanocytic nevus from pigmented neurofibroma.     

Giant Congenital Melanocytic Nevus with Developmental Dysplasia of Bilateral Hip: A Rare Association

Giant congenital melanocytic nevi are rare congenital disfiguring benign neoplasms with a risk of transformation to malignant melanoma. They often present with various extra-cutaneous features. Here, we describe a case of giant melanocytic nevus with developmental dysplasia of bilateral hip, a novel association.