Progress in research of dermoscopy in differential diagnosis of erythematous dermatosis on the scalp

doi:10.3877/cma.j.issn.1674-0785.2024.07.013

Abstract

Abstract:

Erythematous lesions on the scalp are common clinical manifestations that can be caused by a variety of diseases， including psoriasis， seborrheic dermatitis， contact dermatitis， lichen planopilaris， actinic keratosis， etc. As a non-invasive imaging technique， dermoscopy can assist in the diagnosis and differential diagnosis of scalp erythema. By reviewing the relevant literature in recent years，this article summarizes the dermoscopic characteristics of the above diseases and the key points for their differential diagnosis.

Key words: Dermoscopy, Scalp, Differential diagnosis, Psoriasis, Seborrheic dermatitis

Hui Chen, Zupeng Zou, Tiantian Zhou, Yidan Zhang, Haiping Zhang. Progress in research of dermoscopy in differential diagnosis of erythematous dermatosis on the scalp[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(07): 692-698.

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References 36

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诊断	临床特征	皮肤镜特点
银屑病	·银白色鳞屑	·银白色鳞屑
	·皮损可累及发际线及发际线外	·规律分布的点状血管或扭曲的环状血管
	·肘部、膝关节伸侧、腰骶部存在皮损	·点状出血
脂溢性皮炎	·油腻毛发	·黄白色鳞屑
	·鼻唇沟、眉毛、耳后区和上胸部，也可见红斑和鳞屑	·细的分支状血管
接触性皮炎	·染发剂等接触史	·黄色渗出物
	·发际线、耳部、耳后、颈部等处存在类似皮疹	·多形性血管
毛发扁平苔藓	·脱发	·毛囊周围红斑和鳞屑
	·存在典型皮肤、粘膜和/或甲受累	·毛囊开口缺失
日光性角化	·红斑（粉红色至红褐色）	·草莓征
	·干燥、黏附的鳞屑	·玫瑰花瓣征
		·红色星爆状模式
		·毛囊周围大的不规则线性血管和外周色素沉着
头皮玫瑰痤疮	·鼻部、下颏部、面颊部、前额部存在典型皮损	·毛囊周围鳞屑
		·多边形/分支状血管
头癣	·头皮红斑	·逗号发/螺旋发/之字形毛发/摩斯码毛发
	·断发	·断发
		·黑点征
		·淡黄色小点、红斑、毛囊周围鳞屑
秃发性毛囊炎	·毛囊性脓疱、丘疹，红斑	·簇状发
	·毛囊周围角化过度	·早期为毛囊间增厚的瘢痕疙瘩样区域
	·毛囊发生不可逆的破坏呈现瘢痕性秃发	·晚期为毛囊开口消失，毛囊周围星爆模式，白色和乳红色区域
DLE	·脱发	·早期为毛囊角栓和分支状血管
	·红色/紫红色斑块伴毛囊角栓	·晚期为毛囊开口缺失和分支状血管
皮肌炎	·脱发	·线性血管/线性弯曲血管/点状血管
	·红斑	·黄点征、毛发直径多样性、毛囊内蜂窝状模式
	·皮肤异色症	·毛囊间和毛囊开口周围色素沉着、毛囊周围红斑、毛囊周围鳞屑
	·合并皮肌炎其它典型皮损
	·合并近端肢无力
天疱疮	·红斑、糜烂、痂皮	·渗出、黄色出血性痂皮
	·合并粘膜水疱和糜烂	·黄色弥漫性鳞屑
		·点状血管

诊断	临床特征	皮肤镜特点
银屑病	·银白色鳞屑	·银白色鳞屑
	·皮损可累及发际线及发际线外	·规律分布的点状血管或扭曲的环状血管
	·肘部、膝关节伸侧、腰骶部存在皮损	·点状出血
脂溢性皮炎	·油腻毛发	·黄白色鳞屑
	·鼻唇沟、眉毛、耳后区和上胸部，也可见红斑和鳞屑	·细的分支状血管
接触性皮炎	·染发剂等接触史	·黄色渗出物
	·发际线、耳部、耳后、颈部等处存在类似皮疹	·多形性血管
毛发扁平苔藓	·脱发	·毛囊周围红斑和鳞屑
	·存在典型皮肤、粘膜和/或甲受累	·毛囊开口缺失
日光性角化	·红斑（粉红色至红褐色）	·草莓征
	·干燥、黏附的鳞屑	·玫瑰花瓣征
		·红色星爆状模式
		·毛囊周围大的不规则线性血管和外周色素沉着
头皮玫瑰痤疮	·鼻部、下颏部、面颊部、前额部存在典型皮损	·毛囊周围鳞屑
		·多边形/分支状血管
头癣	·头皮红斑	·逗号发/螺旋发/之字形毛发/摩斯码毛发
	·断发	·断发
		·黑点征
		·淡黄色小点、红斑、毛囊周围鳞屑
秃发性毛囊炎	·毛囊性脓疱、丘疹，红斑	·簇状发
	·毛囊周围角化过度	·早期为毛囊间增厚的瘢痕疙瘩样区域
	·毛囊发生不可逆的破坏呈现瘢痕性秃发	·晚期为毛囊开口消失，毛囊周围星爆模式，白色和乳红色区域
DLE	·脱发	·早期为毛囊角栓和分支状血管
	·红色/紫红色斑块伴毛囊角栓	·晚期为毛囊开口缺失和分支状血管
皮肌炎	·脱发	·线性血管/线性弯曲血管/点状血管
	·红斑	·黄点征、毛发直径多样性、毛囊内蜂窝状模式
	·皮肤异色症	·毛囊间和毛囊开口周围色素沉着、毛囊周围红斑、毛囊周围鳞屑
	·合并皮肌炎其它典型皮损
	·合并近端肢无力
天疱疮	·红斑、糜烂、痂皮	·渗出、黄色出血性痂皮
	·合并粘膜水疱和糜烂	·黄色弥漫性鳞屑
		·点状血管

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