{"title":"皮肌炎、系统性红斑狼疮和系统性硬化症的trichoscopy征象:150例患者的比较研究。","authors":"Kumutnart Chanprapaph, Preeyachat Limtong, Pintip Ngamjanyaporn, Poonkiat Suchonwanit","doi":"10.1159/000520297","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hair and scalp involvement is prevalent in connective tissue diseases (CTDs). Trichoscopic features may provide a diagnostic implementation and enable differentiation among CTDs; however, a direct comparison of these signs among CTD patients is lacking.</p><p><strong>Objectives: </strong>To compare trichoscopic findings in dermatomyositis (DM), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc) as well as determine their distinctive features and associations with disease activity.</p><p><strong>Methods: </strong>Trichoscopic photographs were taken from DM, SLE, and SSc patients and further evaluated for hair shaft and scalp surface abnormalities. Data regarding patients' clinical manifestations, laboratory results, and disease activity were analyzed.</p><p><strong>Results: </strong>One hundred fifty participants, consisting of 30 DM, 60 SLE, and 60 SSc patients, were included. Perifollicular red-brown pigmentation, brown scattered pigmentation, and white patches were exclusive findings in DM, SLE, and SSc, respectively (p < 0.001). A multinomial logistic regression analysis revealed that DM demonstrated higher odds for having microaneurysmal blood vessels than SLE and SSc (odds ratio [OR] = 22.22, 95% confidence interval [CI] = 1.73-285.13, p = 0.017, and OR = 15.34, 95% CI = 1.36-177.59, p = 0.029, respectively). Polymorphic vessels forming a telangiectatic network suggested SSc over SLE (OR = 12.83, 95% CI = 1.35-121.98, p = 0.026), while avascular areas were more pronounced in SSc than DM and SLE (OR = 43.24, 95% CI = 5.17-361.67, p = 0.001, and OR = 0.03, 95% CI = 0.01-0.24, p = 0.001, respectively). In a quantile regression analysis, perifollicular red-brown pigmentation, reduction in hair diameter, and the absence of thin arborizing vessels were linked to higher disease activity in DM, SLE, and SSc, respectively (all p < 0.05).</p><p><strong>Conclusions: </strong>Trichoscopy is a valuable tool possessing diagnostic and prognostic values for CTDs. Specific trichoscopic features allow adequate distinction between DM, SLE, and SSc and may help identify active disease.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"677-687"},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393826/pdf/","citationCount":"5","resultStr":"{\"title\":\"Trichoscopic Signs in Dermatomyositis, Systemic Lupus Erythematosus, and Systemic Sclerosis: A Comparative Study of 150 Patients.\",\"authors\":\"Kumutnart Chanprapaph, Preeyachat Limtong, Pintip Ngamjanyaporn, Poonkiat Suchonwanit\",\"doi\":\"10.1159/000520297\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hair and scalp involvement is prevalent in connective tissue diseases (CTDs). Trichoscopic features may provide a diagnostic implementation and enable differentiation among CTDs; however, a direct comparison of these signs among CTD patients is lacking.</p><p><strong>Objectives: </strong>To compare trichoscopic findings in dermatomyositis (DM), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc) as well as determine their distinctive features and associations with disease activity.</p><p><strong>Methods: </strong>Trichoscopic photographs were taken from DM, SLE, and SSc patients and further evaluated for hair shaft and scalp surface abnormalities. Data regarding patients' clinical manifestations, laboratory results, and disease activity were analyzed.</p><p><strong>Results: </strong>One hundred fifty participants, consisting of 30 DM, 60 SLE, and 60 SSc patients, were included. Perifollicular red-brown pigmentation, brown scattered pigmentation, and white patches were exclusive findings in DM, SLE, and SSc, respectively (p < 0.001). A multinomial logistic regression analysis revealed that DM demonstrated higher odds for having microaneurysmal blood vessels than SLE and SSc (odds ratio [OR] = 22.22, 95% confidence interval [CI] = 1.73-285.13, p = 0.017, and OR = 15.34, 95% CI = 1.36-177.59, p = 0.029, respectively). Polymorphic vessels forming a telangiectatic network suggested SSc over SLE (OR = 12.83, 95% CI = 1.35-121.98, p = 0.026), while avascular areas were more pronounced in SSc than DM and SLE (OR = 43.24, 95% CI = 5.17-361.67, p = 0.001, and OR = 0.03, 95% CI = 0.01-0.24, p = 0.001, respectively). In a quantile regression analysis, perifollicular red-brown pigmentation, reduction in hair diameter, and the absence of thin arborizing vessels were linked to higher disease activity in DM, SLE, and SSc, respectively (all p < 0.05).</p><p><strong>Conclusions: </strong>Trichoscopy is a valuable tool possessing diagnostic and prognostic values for CTDs. Specific trichoscopic features allow adequate distinction between DM, SLE, and SSc and may help identify active disease.</p>\",\"PeriodicalId\":144585,\"journal\":{\"name\":\"Dermatology (Basel, Switzerland)\",\"volume\":\" \",\"pages\":\"677-687\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393826/pdf/\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Dermatology (Basel, Switzerland)\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000520297\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/12/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Dermatology (Basel, Switzerland)","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000520297","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/12/8 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 5
摘要
背景:结缔组织病(CTDs)中累及头发和头皮是很常见的。三毛镜特征可以提供诊断手段，并使CTDs之间能够区分;然而，缺乏对CTD患者这些体征的直接比较。目的:比较皮肌炎(DM)、系统性红斑狼疮(SLE)和系统性硬化症(SSc)的毛细镜表现，并确定它们的特点及其与疾病活动性的关系。方法:对DM、SLE和SSc患者进行毛发镜检查，进一步评估毛干和头皮表面异常。分析患者的临床表现、实验室结果和疾病活动度等数据。结果:150名参与者，包括30名糖尿病患者，60名SLE患者和60名SSc患者。毛囊周围红棕色色素沉着、棕色散在色素沉着和白色斑块分别是DM、SLE和SSc独有的发现(p < 0.001)。多项logistic回归分析显示，DM出现微动脉瘤血管的几率高于SLE和SSc(比值比[OR] = 22.22, 95%可信区间[CI] = 1.73-285.13, p = 0.017; OR = 15.34, 95% CI = 1.36-177.59, p = 0.029)。多态血管形成毛细血管扩张网络提示SSc高于SLE (OR = 12.83, 95% CI = 1.35-121.98, p = 0.026)，而无血管区域在SSc中比DM和SLE更为明显(OR = 43.24, 95% CI = 5.17-361.67, p = 0.001, OR = 0.03, 95% CI = 0.01-0.24, p = 0.001)。在分位数回归分析中，毛囊周围的红棕色色素沉着、毛径减少和缺乏薄的树形血管分别与DM、SLE和SSc的疾病活动性增高有关(均p < 0.05)。结论:毛发镜检查是一种有价值的工具，对CTDs具有诊断和预后价值。特定的trichoscopy特征可以充分区分DM、SLE和SSc，并可能有助于识别活动性疾病。
Trichoscopic Signs in Dermatomyositis, Systemic Lupus Erythematosus, and Systemic Sclerosis: A Comparative Study of 150 Patients.
Background: Hair and scalp involvement is prevalent in connective tissue diseases (CTDs). Trichoscopic features may provide a diagnostic implementation and enable differentiation among CTDs; however, a direct comparison of these signs among CTD patients is lacking.
Objectives: To compare trichoscopic findings in dermatomyositis (DM), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc) as well as determine their distinctive features and associations with disease activity.
Methods: Trichoscopic photographs were taken from DM, SLE, and SSc patients and further evaluated for hair shaft and scalp surface abnormalities. Data regarding patients' clinical manifestations, laboratory results, and disease activity were analyzed.
Results: One hundred fifty participants, consisting of 30 DM, 60 SLE, and 60 SSc patients, were included. Perifollicular red-brown pigmentation, brown scattered pigmentation, and white patches were exclusive findings in DM, SLE, and SSc, respectively (p < 0.001). A multinomial logistic regression analysis revealed that DM demonstrated higher odds for having microaneurysmal blood vessels than SLE and SSc (odds ratio [OR] = 22.22, 95% confidence interval [CI] = 1.73-285.13, p = 0.017, and OR = 15.34, 95% CI = 1.36-177.59, p = 0.029, respectively). Polymorphic vessels forming a telangiectatic network suggested SSc over SLE (OR = 12.83, 95% CI = 1.35-121.98, p = 0.026), while avascular areas were more pronounced in SSc than DM and SLE (OR = 43.24, 95% CI = 5.17-361.67, p = 0.001, and OR = 0.03, 95% CI = 0.01-0.24, p = 0.001, respectively). In a quantile regression analysis, perifollicular red-brown pigmentation, reduction in hair diameter, and the absence of thin arborizing vessels were linked to higher disease activity in DM, SLE, and SSc, respectively (all p < 0.05).
Conclusions: Trichoscopy is a valuable tool possessing diagnostic and prognostic values for CTDs. Specific trichoscopic features allow adequate distinction between DM, SLE, and SSc and may help identify active disease.
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