红头皮的鉴别诊断。毛发镜检查的重要性。

IF 3.7 4区 医学 Q1 DERMATOLOGY
Anna Waśkiel-Burnat, Joanna Czuwara, Leszek Blicharz, Małgorzata Olszewska, Lidia Rudnicka
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引用次数: 0

摘要

头皮发红是一种常见的症状,在日常临床实践中可能构成诊断和治疗挑战。引起弥漫性头皮红斑的众多疾病包括银屑病、脂溢性皮炎、接触性皮炎、弥漫性扁平苔藓、皮肌炎和头皮红斑痤疮。准确的诊断对最佳治疗结果至关重要。组织学最常鉴别潜在的疾病,但它需要头皮活检。在许多情况下,临床检查和毛发镜检查相结合就足以确定正确的诊断。银屑病的主要毛镜特征是银白色鳞屑、规则分布的点状(肾小球)血管或扭曲的红环和点状出血。脂溢性皮炎的典型特征是黄白色的鳞屑和稀疏的树枝状血管。接触性皮炎的特征是存在黄色渗出物和多态性血管,而毛囊周围结垢和缺乏毛囊开口的红斑是扁平苔藓的典型表现。在头皮皮肌炎中,可以检测到毛囊间和毛囊周色素沉着的弯曲和树状血管。头皮红斑痤疮最具特征的特征是毛囊周围的鳞屑和树枝状血管。这篇综述还总结了这些疾病的组织学特征和治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Differential diagnosis of red scalp: the importance of trichoscopy.

Red scalp is a common complaint that may constitute a diagnostic and therapeutic challenge in daily clinical practice. Among the numerous diseases to cause diffuse scalp erythema are psoriasis, seborrhoeic dermatitis, contact dermatitis, diffuse lichen planopilaris, dermatomyositis and scalp rosacea. Accurate diagnosis is crucial for optimal treatment outcomes. Histology most frequently discriminates the underlying condition, but it requires scalp biopsy. In many cases, the combination of clinical examination and trichoscopy is sufficient for establishing the correct diagnosis. The main trichoscopic features of psoriasis are silver-white scaling, regularly distributed dotted (glomerular) vessels or twisted red loops, and punctate haemorrhages. Yellowish-white scaling and thin arborizing vessels are typical features of seborrhoeic dermatitis. Contact dermatitis is characterized by the presence of yellow exudate and polymorphic vessels, while perifollicular scaling and erythema with the lack of follicular openings are typical findings in lichen planopilaris. In scalp dermatomyositis, tortuous and arborizing vessels with interfollicular and perifollicular pigmentation may be detected. The most characteristic features of scalp rosacea are perifollicular scaling and polygonal/arborizing vessels. This review also summarizes histological features and therapeutic options for these conditions.

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来源期刊
CiteScore
3.20
自引率
2.40%
发文量
389
审稿时长
3-8 weeks
期刊介绍: Clinical and Experimental Dermatology (CED) is a unique provider of relevant and educational material for practising clinicians and dermatological researchers. We support continuing professional development (CPD) of dermatology specialists to advance the understanding, management and treatment of skin disease in order to improve patient outcomes.
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