ABSTRACT
Objective@#To describe the dermoscopic features of extramammary Paget′s disease (EMPD) and chronic eczema of the vulva, and to explore the value of dermoscopy in the diagnosis and differential diagnosis of the above diseases.@*Methods@#Dermoscopic images were collected from 20 patients with histopathologically confirmed vulvar EMPD and 16 patients with clinically confirmed chronic eczema of the vulva in Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Pekin Union Medical College from January 2017 to April 2018, and retrospectively analyzed. Fisher′s exact test was used to compare the prevalence of dermoscopic features between the two groups.@*Results@#As dermoscopy showed, the milky red background was observed in 19 EMPD patients and in only 1 patient with chronic eczema, and there was a significant difference in the prevalence of milky red background between the two groups (P < 0.001) . White scales were the most common desquamation, and were observed in 9 EMPD patients and 13 patients with chronic eczema (P = 0.128) . Blood vessels were uniformly distributed in EMPD patients, including dotted-globular vessels in 19 and linear vessels in 14, while blood vessels were distributed in a patchy or clustered pattern in the patients with chronic eczema, including dotted-globular vessels in 16 and linear vessels in 7. There was a significant difference in the prevalence of different distribution patterns of blood vessels between the two groups (P < 0.001) . Bright white streaks, bright white structureless area and reticular structure were observed in 19, 20 and 19 EMPD patients respectively, and in 1, 1 and 1 patient with chronic eczema respectively, and there were significant differences in the prevalence of the above 3 structures between the two diseases (all P < 0.001) .@*Conclusion@#Vulvar EMPD and chronic eczema both show characteristic dermoscopic features, and dermoscopy is of great value to the diagnosis and differential diagnosis of EMPD.
ABSTRACT
Objective To describe the dermoscopic features of extramammary Paget's disease (EMPD) and chronic eczema of the vulva,and to explore the value of dermoscopy in the diagnosis and differential diagnosis of the above diseases.Methods Dermoscopic images were collected from 20 patients with histopathologically confirmed vulvar EMPD and 16 patients with clinically confirmed chronic eczema of the vulva in Hospital for Skin Diseases,Chinese Academy of Medical Sciences and Pekin Union Medical College from January 2017 to April 2018,and retrospectively analyzed.Fisher's exact test was used to compare the prevalence of dermoscopic features between the two groups.Results As dermoscopy showed,the milky red background was observed in 19 EMPD patients and in only 1 patient with chronic eczema,and there was a significant difference in the prevalence of milky red background between the two groups (P ＜0.001).White scales were the most common desquamation,and were observed in 9 EMPD patients and 13 patients with chronic eczema (P =0.128).Blood vessels were uniformly distributed in EMPD patients,including dotted-globular vessels in 19 and linear vessels in 14,while blood vessels were distributed in a patchy or clustered pattern in the patients with chronic eczema,including dotted-globular vessels in 16 and linear vessels in 7.There was a significant difference in the prevalence of different distribution patterns of blood vessels between the two groups (P ＜ 0.001).Bright white streaks,bright white structureless area and reticular structure were observed in 19,20 and 19 EMPD patients respectively,and in 1,1 and 1 patient with chronic eczema respectively,and there were significant differences in the prevalence of the above 3 structures between the two diseases (all P ＜ 0.001).Conclusion Vulvar EMPD and chronic eczema both show characteristic dermoscopic features,and dermoscopy is of great value to the diagnosis and differential diagnosis of EMPD.
ABSTRACT
Objective To develop a new strategy for preparing large-area full-thickness skin grafts with donor incisions small enough to allow direct suture under low pressure.Methods A geometrical analysis was carried out to design the best strategy to obtain skin grafts with minimal donor defect.In this strategy,two semicircular donor skin grafts are subjected to a malpositioned joining to form a circle which is equal in size to the large-area skin defect.Seven patients with cutaneous malignancy were managed by this operation regimen,including three cases of basal cell carcinoma,three cases of squamous cell carcinoma,and one case of malignant melanoma.Tumors were located in the face or head in five patients,and in feet in two patients.Results The width of donor incisions was significantly reduced by this strategy,and donor defects were sutured directly with the minimal loss of donor graft.Of the five patients with malignancies of the head or face,three achieved complete survival of skin grafts,two experienced mild erosion at the margin of skin grafts.A 10％-20％ necrosis of skin graft was observed in the sole of feet in 2 patients,which healed 1-2 months after dressing changes.Conclusion Joined grafts of equal size may be an effective approach to the repair of large skin defect.