儿童和青少年掌跖黑素细胞痣的皮肤镜下特征分析

doi:10.12372/jcp.2026.25e1605

摘要/Abstract

摘要：

目的探讨儿童和青少年掌跖部位黑素细胞痣的皮肤镜特征，并分析不同皮肤镜模式在不同解剖部位的分布情况。方法回顾性分析2022年6月至2025年6月在皮肤科就诊的掌跖黑素细胞痣患儿的临床资料及皮肤镜图像。结果共纳入129例患儿的138个黑素细胞痣，其中120例为单个掌跖黑素细胞痣，其余9例为多发掌跖黑素细胞痣。女57例（44.2%）、男72例（55.8%），中位年龄5.00（2.75~7.00）岁。34例患儿的39个黑素细胞痣位于手掌，95例患儿的99个黑素细胞痣位于足底。最常见的皮肤镜模式为皮沟平行模式（43/138，31.2%），其次为豌豆荚模式（32/138，23.2%）和纤维状模式（28/138，20.3%）。不同皮肤镜模式之间不同解剖部位分布差异有统计学意义（χ²=50.78，P<0.001），两两比较采用卡方分割，发现足弓部位网格样模式比例高于皮沟平行模式、纤维状模式、豌豆荚模式，足底承重部位（包括跖骨区、足跟部、足中部外侧区）纤维状模式比例高于网格样模式，手指掌侧部位豌豆荚模式比例高于纤维状模式，差异均有统计学意义（P<0.005）。结论儿童和青少年掌跖部位黑素细胞痣的皮肤镜模式可能与解剖位置相关，网格样模式在足弓部位更常见，纤维状模式好发于足底承重部位，而豌豆荚模式常见于手指掌侧。

关键词: 掌跖, 黑素细胞痣, 皮肤镜, 青少年, 儿童

Abstract:

Objective To explore the dermoscopic characteristics of melanocytic nevi on the acral volar area in children and adolescents, and to analyze the distribution of different dermoscopic patterns in different anatomic localization. Methods The clinical data and dermoscopic images of patients with acral volar melanocytic nevi in Dermatology Department from June 2022 to June 2025 were analyzed retrospectively. Results A total of 138 melanocytic nevi in 129 pediatric patients were included, among which 120 cases were single acral volar melanocytic nevi and the remaining 9 cases were multiple acral volar melanocytic nevi. Among them, there were 57 girls (44.2%) and 72 boys (55.8%), with a median age of 5.00 (2.75-7.00) years. Among the 34 patients, 39 melanocytic nevi were located on the palms, and in 95 patients, 99 melanocytic nevi were located on the soles. The most common dermoscopic pattern was the parallel furrow pattern (43/138, 31.2%), followed by the the peas-in-a-pod pattern (32/138, 23.2%) and the fibrillar pattern (28/138, 20.3%). There is a statistically significant difference in the distribution of different anatomic localisation among different dermoscopic patterns (χ²=50.78, P<0.001). The chi-square partition test was used for pairwise comparisons, and it was found that the lattice-like pattern in the plantar arch area had a higher proportion compared to the parallel furrow pattern, the fibrillar pattern, and the peas-in-a-pod pattern. In the weight-bearing area of the sole (including the metatarsal area, the heel area, and the lateral midfoot area), the proportion of the fibrillar pattern was higher than that of the lattice-like pattern. In the volar surface of the fingers, the proportion of the peas-in-a-pod pattern was higher than that of the fibrillar pattern. All differences were statistically significant (P<0.005). Conclusions The dermoscopic patterns of acral volar melanocytic nevi in children and adolescents may be related to the anatomic localization. The lattice-like pattern is more common in the plantar arch area, the fibrillar pattern is more likely to occur in the weight-bearing area of the sole, and the peas-in-a-pod pattern is often seen on the volar surface of the fingers.

Key words: acral volar, melanocytic nevi, dermoscopy, adolescent, child

中图分类号:

董瑛, 曹婷婷, 吴健平, 张莉, 葛宏松. 儿童和青少年掌跖黑素细胞痣的皮肤镜下特征分析[J]. 临床儿科杂志, 2026, 44(5): 418-423.

DONG Ying, CAO Tingting, WU Jianping, ZHANG li, GE Hongsong. Dermoscopic characteristics analysis of acral volar melanocytic nevi in children and adolescents[J]. Journal of Clinical Pediatrics, 2026, 44(5): 418-423.

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参考文献 20

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部位	皮肤镜模式									总计
部位	皮沟平行模式	网格样模式	纤维状模式	网状模式	球状模式	均质模式	豌豆荚模式	复合模式	不典型模式	总计
跖骨区	10(32.3)	2(6.5)	10(32.3)	0(0)	1(3.2)	0(0)	5(16.1)	2(6.5)	1(3.2)	31(22.5)
足跟部	7(24.1)	0(0)	12(41.4)	0(0)	0(0)	0(0)	6(20.7)	2(6.9)	2(6.9)	29(21.0)
足中部外侧区	2(18.2)	0(0)	2(18.2)	0(0)	0(0)	0(0)	6(54.5)	1(9.1)	0(0)	11(8.0）
足弓部	4(23.5)	6(35.3)	2(11.8)	0(0)	1(5.9)	0(0)	2(11.8)	0(0)	2(11.8)	17(12.3)
足趾跖侧	6(60.0)	0(0)	2(20.0)	0(0)	0(0)	0(0)	1(10.0)	0(0)	1(10.0)	10(7.2)
足底侧缘	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	1(100.0)	0(0)	0(0)	1(0.7)
手指掌侧	7(33.3)	1(4.8)	0(0)	0(0)	4(19.0)	0(0)	9(42.9)	0(0)	0(0)	21(15.2)
近端掌部	2(50.0)	1(25.0)	0(0)	0(0)	1(25.0)	0(0)	0(0)	0(0)	0(0)	4(2.9)
掌中部	0(0)	0(0)	0(0)	0(0)	2(40.0)	0(0)	0(0)	1(20.0)	2(40.0)	5(3.6)
远端掌部	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	1(100.0)	1(0.7)
大鱼际	3(60.0)	0(0)	0(0)	0(0)	0(0)	0(0)	1(20.0)	1(20.0)	0(0)	5(3.6)
小鱼际	2(66.7)	0(0)	0(0)	0(0)	0(0)	0(0)	1(33.3)	0(0)	0(0)	3(2.2)
手掌侧缘	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)
总计	43(31.2)	10(7.2)	28(20.3)	0(0)	9(6.5)	0(0)	32(23.2)	7(5.1)	9(6.5)	138

皮肤镜模式	例数	足弓	足底承重部位	足底其他部位	手指掌侧	手掌其他部位	χ²值	P
皮沟平行模式	43	4(9.3)	19(44.2)	6(14.0)	7(16.3)	7(16.3)	50.78	<0.001
纤维状模式	28	2(7.1)	24(85.7)	2(7.1)	0（0）	0（0）
网格样模式	10	6(60.0)¹⁾²⁾	2(20.0)²⁾	0（0）	1(10.0)	1(10.0)
豌豆荚模式	32	2(6.3)³⁾	17(53.1)	2(6.3)	9(28.1)²⁾	2(6.3)
其他模式	25	3(12.0)	9(36.0)	1(4.0)	4(16.0)	8(32.0)²⁾