Abstract：
BACKGROUND: Both xanthogranuloma and xanthoma clinically manifest as yellowish skin lesions. Historically, the gold standard for diagnosis was skin histopathological examination. Currently, the advent of reflectance confocal microscopy (RCM) offers additional diagnostic support for these diseases by revealing their microscopic features, thereby enhancing the theoretical foundation for diagnosis.
OBJECTIVE: This study aimed to elucidate the distinctive characteristics of RCM images in xanthogranuloma and xanthoma, assess their diagnostic value, and investigate the relationship between RCM and histopathological features, ultimately boosting diagnostic accuracy.
METHODS: RCM and histopathological examinations were conducted on 13 patients with xanthogranuloma and 12 with xanthoma, recruited from our Dermatology Clinic between August 2022 and November 2023. The study involved analyzing RCM image features and correlating them with histopathological findings.
RESULTS: The RCM images of 13 xanthogranuloma and 12 xanthoma cases showed similar features. Xanthogranuloma predominantly exhibited epidermal atrophy and thinning in 6 cases (46.15%). Additionally, in 69.23% of cases, scattered small mononuclear inflammatory cells were infiltrated in the superficial and middle dermis layers. Medium to high refractive cells, predominantly vacuolated and resembling foam, were observed in 61.54% of cases. All cases demonstrated high refractive cells with distinct target-shaped, disc-shaped, horseshoe-like, and flower-ring structures. Concordance rates with histopathological examinations were 69.23, 92.31, 92.31, and 100%, respectively. Regarding xanthoma, epidermal atrophy and thinning occurred in two cases (16.67%), and mononuclear inflammatory cell infiltration was observed in 25% of cases. High refractive cells with the previously mentioned shapes were present in 100% of cases, though only 16.67% displayed these characteristics exclusively. The concordance rates were 66.67, 91.67, 100, and 91.67%, respectively.
CONCLUSIONS: RCM imaging of xanthogranuloma and xanthoma presents distinctive, highly consistent features with their histopathology, offering valuable insights for clinicians in diagnosing and differentiating these conditions.
OBJECTIVE: This study aimed to elucidate the distinctive characteristics of RCM images in xanthogranuloma and xanthoma, assess their diagnostic value, and investigate the relationship between RCM and histopathological features, ultimately boosting diagnostic accuracy.
METHODS: RCM and histopathological examinations were conducted on 13 patients with xanthogranuloma and 12 with xanthoma, recruited from our Dermatology Clinic between August 2022 and November 2023. The study involved analyzing RCM image features and correlating them with histopathological findings.
RESULTS: The RCM images of 13 xanthogranuloma and 12 xanthoma cases showed similar features. Xanthogranuloma predominantly exhibited epidermal atrophy and thinning in 6 cases (46.15%). Additionally, in 69.23% of cases, scattered small mononuclear inflammatory cells were infiltrated in the superficial and middle dermis layers. Medium to high refractive cells, predominantly vacuolated and resembling foam, were observed in 61.54% of cases. All cases demonstrated high refractive cells with distinct target-shaped, disc-shaped, horseshoe-like, and flower-ring structures. Concordance rates with histopathological examinations were 69.23, 92.31, 92.31, and 100%, respectively. Regarding xanthoma, epidermal atrophy and thinning occurred in two cases (16.67%), and mononuclear inflammatory cell infiltration was observed in 25% of cases. High refractive cells with the previously mentioned shapes were present in 100% of cases, though only 16.67% displayed these characteristics exclusively. The concordance rates were 66.67, 91.67, 100, and 91.67%, respectively.
CONCLUSIONS: RCM imaging of xanthogranuloma and xanthoma presents distinctive, highly consistent features with their histopathology, offering valuable insights for clinicians in diagnosing and differentiating these conditions.
摘要：
背景：黄色肉芽肿和黄色瘤在临床上都表现为黄色皮肤病变。历史上,诊断的金标准是皮肤组织病理学检查。目前,反射共聚焦显微镜（RCM）的出现为这些疾病提供了额外的诊断支持，通过揭示它们的微观特征，从而增强了诊断的理论基础。
目的：本研究旨在阐明黄色肉芽肿和黄色瘤的RCM图像的独特特征，评估其诊断价值，并研究RCM与组织病理学特征之间的关系，最终提高诊断准确性。
方法：对13例黄色肉芽肿和12例黄色肉芽肿进行RCM和组织病理学检查，2022年8月至2023年11月从我们的皮肤科诊所招募。该研究涉及分析RCM图像特征并将其与组织病理学发现相关联。
结果：13例黄色肉芽肿和12例黄色肉芽肿的RCM图像表现出相似的特征。黄色肉芽肿以表皮萎缩和变薄为主6例(46.15%)。此外,在69.23%的病例中，散在小的单核细胞炎症细胞浸润在真皮的浅层和中层。中等至高屈光细胞，主要是空泡和类似的泡沫，在61.54%的病例中观察到。所有病例均表现出高屈光细胞，具有明显的目标形状，圆盘形,马蹄形,和花环结构。与组织病理学检查的符合率分别为69.23、92.31、92.31和100%,分别。关于黄色瘤，表皮萎缩和变薄2例(16.67%),在25％的病例中观察到单核炎症细胞浸润。具有前面提到的形状的高屈光细胞存在于100%的病例中,尽管只有16.67%的人专门展示了这些特征。符合率分别为66.67、91.67、100和91.67%,分别。
结论：黄色肉芽肿和黄色瘤的RCM成像呈现独特的，其组织病理学特征高度一致，为临床医生诊断和鉴别这些疾病提供有价值的见解。
目的：本研究旨在阐明黄色肉芽肿和黄色瘤的RCM图像的独特特征，评估其诊断价值，并研究RCM与组织病理学特征之间的关系，最终提高诊断准确性。
方法：对13例黄色肉芽肿和12例黄色肉芽肿进行RCM和组织病理学检查，2022年8月至2023年11月从我们的皮肤科诊所招募。该研究涉及分析RCM图像特征并将其与组织病理学发现相关联。
结果：13例黄色肉芽肿和12例黄色肉芽肿的RCM图像表现出相似的特征。黄色肉芽肿以表皮萎缩和变薄为主6例(46.15%)。此外,在69.23%的病例中，散在小的单核细胞炎症细胞浸润在真皮的浅层和中层。中等至高屈光细胞，主要是空泡和类似的泡沫，在61.54%的病例中观察到。所有病例均表现出高屈光细胞，具有明显的目标形状，圆盘形,马蹄形,和花环结构。与组织病理学检查的符合率分别为69.23、92.31、92.31和100%,分别。关于黄色瘤，表皮萎缩和变薄2例(16.67%),在25％的病例中观察到单核炎症细胞浸润。具有前面提到的形状的高屈光细胞存在于100%的病例中,尽管只有16.67%的人专门展示了这些特征。符合率分别为66.67、91.67、100和91.67%,分别。
结论：黄色肉芽肿和黄色瘤的RCM成像呈现独特的，其组织病理学特征高度一致，为临床医生诊断和鉴别这些疾病提供有价值的见解。
