线状和漩涡状痣样过度黑素沉着病一例

摘要

患者男,20岁.出生后全身开始出现色素斑,逐渐增多并排列成条纹状或漩涡状.无黏膜、眼睛、掌跖受累,损害至成年仍未消退.皮肤科检查:皮损分布广泛,躯干、四肢皆为淡褐色或深棕色条状或漩涡状排列的色素沉着斑纹,沿Blaschko线分布,斑纹较宽,在躯干部略呈漩涡状,弧形,四肢呈条状.组织病理检查:基底层色素增加,无色素失禁.诊断为线状和漩涡状痣样过度黑素沉着病.给予Q开关532 nm激光治疗1次,尚无明显效果,仍在随访中.本病需与色素失禁症和早期线状表皮痣相鉴别.%A case of linear and whorled nevoid hypermelanosis is reported.A 20-year-old male patient developed hyperpigmented macules over the trunk and extremities soon after birth,which progressively increased.The lesions were arranged in streaks or whorles.Mucous membranes,eyes,palms and soles were spared.Dermatological examination revealed generalized,light tan or deep brown,broad-stripe hyperpigmentation along the Blaschko's lines,which were arranged in streaks on the extremities and in whorles or are shape on the trunk.Skin biopsy revealed increased pigmentation of the basal layer without incontinence of pigmentation.He was diagnosed with linear and whorled nevoid hypermelanosis,and received one-session treatment with Q-switched laser (532 nm),but no obvious improvement was observed.The patient was still followed up.This disease should be diferenfiated from other pigmented disorders,such as incontinentia pigmenti and early linear epidermal nevi.