Abstract：
Lichen striatus (LS), linear psoriasis (LPs), linear cutaneous lupus erythematosus (LCLE) and linear lichen planus (LLP) often have similar clinical manifestations, which makes clinical diagnosis with the naked eye difficult; therefore, they are easily misdiagnosed. The purpose of this study was to determine whether reflectance confocal microscopy (RCM) is helpful in differentiating between these four linear dermatoses in children. This retrospective study included 14 patients with LS, nine with LPs, eight with LCLE and 12 with LLP. All patients were analysed using RCM, and biopsies were collected from lesions previously imaged by RCM. For LS, the dermal papillary rings were partially absent, but when present, manifested with small, homogeneously round, bright cells and occasionally highly refractive plump cellular structures, aggregated in clusters. LPs exhibited dark cyst-like structures with small, bright, round cells aggregated at the epidermal level; at the dermal-epidermal junction, homogeneously distributed, enlarged, faint dermal papillary rings and numerous enlarged low-refractive canalicular structures were observed in the superficial dermis. LCLE and LLP exhibited similar manifestations, including epidermal disarray, almost total absence of dermal papillary rings, and various sized refractive structures densely distributed in the dermis. The key distinguishing features of LCLE were the different sized structures mainly clustered around hair follicles, while LLP demonstrated dense structures with a scattered distribution. RCM may be used to distinguish between the key features of LS, LPs, LCLE and LLP in children.
摘要：
纹状体地衣（LS），线性银屑病（LPs），线状皮肤红斑狼疮(LCLE)和线状扁平苔藓(LLP)常具有相似的临床表现,这使得肉眼难以进行临床诊断；因此，他们很容易被误诊。这项研究的目的是确定反射共聚焦显微镜（RCM）是否有助于区分儿童的这四种线性皮肤病。这项回顾性研究包括14例LS患者，九个有LP，八个与LCLE和12与LLP。所有患者均使用RCM进行分析，和活检是从先前通过RCM成像的病变中收集的。对于LS，真皮乳头状环部分缺失，但是当存在时，表现为小，均匀圆形，明亮的细胞和偶尔高度折射的丰满的细胞结构，在集群中聚合。LP表现出黑色的囊肿样结构，小，明亮,圆形细胞聚集在表皮水平；在真皮-表皮交界处，均匀分布，放大，在真皮浅层观察到微弱的真皮乳头状环和许多扩大的低屈光小管结构。LCLE和LLP表现出相似的表现，包括表皮紊乱,几乎完全没有真皮乳头状环，和各种大小的折射结构密集分布在真皮中。LCLE的主要区别特征是毛囊周围聚集的不同大小的结构，而LLP表现出分散分布的致密结构。RCM可用于区分LS的关键特征，LP,儿童LCLE和LLP。
