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除白癜风外的获得性色素减退性疾病

Authors
Mi Ryung Roh, MD, PhD
Sang Ho Oh, MD, PhD
Section Editor
Hensin Tsao, MD, PhD
Deputy Editor
Rosamaria Corona, MD, DSc
Translators
吴文育, 主任医师，教授

引言

人体皮肤的颜色主要由两种黑色素决定：黑褐色的真黑色素和红黄色的褐黑色素。其他重要的贡献因素包括：毛细血管血流量、生色团(如，胡萝卜素或番茄红素)，以及真皮的胶原含量。黑色素增加或减少、黑色素分布异常、血红蛋白下降或外源性物质的沉积均可导致皮肤色素沉着的改变[1]。

“色素减退”是一个一般性术语，指任何形式的皮肤色素沉着的减少或缺失，而“黑素减少症”则更具体地指表皮黑色素的减少。色素减退性疾病可能是先天性或获得性的、弥漫性(广泛性)或局限性的，可单独发生或与多种先天性或获得性疾病相关[2,3]。

本专题将总结除白癜风外的获得性色素减退性疾病。白癜风将单独讨论。色素增多性疾病也将单独讨论。 (参见“白癜风的发病机制、临床特征及诊断”和“白癜风的治疗与预后”和“色素沉着过度性疾病患者概述”)

诊断方法

许多情况下，色素减退性疾病的诊断是基于详细的病史和体格检查结果做出的临床诊断。皮损的形态、颜色(色素减退或色素脱失)、分布和模式是诊断的重要线索。然而，如果临床诊断不确定，可能需要Wood灯检查、皮肤活检以及额外的实验室检查。色素减退性疾病的鉴别诊断请参见此流程图(诊断流程 1)。

患者评估 — 患者的初始评估包括详细的家族史和个人史以及全面的体格检查，查体应包括仔细寻找其他的皮肤和皮肤外体征和症状。

                                       

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Literature review current through: 2017-06 . | This topic last updated: 2016-07-25.
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