Background:

When physicians see an umbilical nodule, most of them instinctively recall the Sister Mary Joseph nodule. Therefore, dermatologists need to recognize umbilical dermatoses that can be mistaken for the Sister Mary Joseph nodules. This study aimed to describe the different kinds of benign umbilical tumors as well as elucidate the factors that can be used to distinguish the Sister Mary Joseph nodule from these tumors.

Methods:

The “benign umbilical tumor” group included 19 patients, whereas the “Sister Mary Joseph nodule” group comprised 30 patients (2 from our department, 28 from PubMed search). We compared the clinical and dermoscopic findings between 2 groups.

Results:

In the “benign umbilical tumor” group, the most common diagnosis was dermatofibroma (5/19), followed by keloid (3/19), and soft fibroma (3/19). These tumors had various colors (red, brown to black, and flesh colored) and exhibit characteristic surface changes (eg, verrucous changes in epidermal nevi and verrucae). Conversely, most Sister Mary Joseph nodules have an erythematous color, oozing or ulceration on the surface, and nearby satellite lesions. Furthermore, the dermoscopic findings of Sister Mary Joseph nodules showed a polymorphous vascular pattern and a white or milky-red, amorphous area. Benign lesions showed different dermoscopic patterns: pigment networks with white areas (dermatofibromas), thrombosed capillaries (verrucae), and the “pore sign” (epidermal cysts).

Conclusions:

Various cutaneous tumors can be mistaken for the Sister Mary Joseph nodule when they develop on the umbilicus; the clinical and dermoscopic differences found in this study may be useful for establishing a differential diagnosis.

中文翻译：

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类似于玛丽约瑟夫姐妹结节的良性脐部肿瘤

背景：

当医生看到脐部结节时，他们中的大多数人都会本能地回忆起玛丽约瑟夫姐妹结节。因此，皮肤科医生需要识别可能被误认为是玛丽约瑟夫姐妹结节的脐部皮肤病。本研究旨在描述不同种类的良性脐部肿瘤，并阐明可用于区分玛丽约瑟夫姐妹结节与这些肿瘤的因素。

方法：

“良性脐肿瘤”组包括 19 名患者，而“玛丽约瑟夫姐妹结节”组包括 30 名患者（2 名来自我科，28 名来自 PubMed 搜索）。我们比较了两组的临床和皮肤镜检查结果。

结果：

在“良性脐部肿瘤”组中，最常见的诊断是皮肤纤维瘤（5/19），其次是瘢痕疙瘩（3/19）和软纤维瘤（3/19）。这些肿瘤有不同的颜色（红色、棕色到黑色和肉色）并表现出特征性的表面变化（例如，表皮痣和疣的疣状变化）。相反，大多数玛丽约瑟夫姐妹结节呈红斑，表面渗出或溃疡，附近有卫星病变。此外，玛丽约瑟夫姐妹结节的皮肤镜检查结果显示多形血管模式和白色或乳红色无定形区域。良性病变表现出不同的皮肤镜模式：带白色区域的色素网（皮肤纤维瘤）、血栓形成的毛细血管（疣）和“毛孔征”（表皮囊肿）。

结论：

脐部出现的各种皮肤肿瘤可能被误认为是玛丽约瑟夫姐妹结节；本研究中发现的临床和皮肤镜检查差异可能有助于建立鉴别诊断。