背景：传染性软疣（MC），米利亚,毛发角化病（KP），扁平疣（VP），脂溢性角化病(SK),青少年黄色肉芽肿（JXG）是儿童面部常见的丘疹性皮肤病，外观相似。使用反射共聚焦显微镜（RCM）对面部丘疹皮肤病进行体内评估有助于诊断儿童的这些模糊病变。本研究的目的是阐明MC的RCM特征，米利亚,KP,VP,SK,并探讨RCM对这些常见面部丘疹性皮肤病的临床应用价值。
方法：我们招募了113名明确的面部丘疹性皮肤病患者，包括21名MC患者，17名米利亚患者，19例KP患者，36例VP，8名SK患者，和12名JXG患者。我们使用RCM评估了六种面部丘疹皮肤病的特征和区别特征。
结果：6种皮肤病的主要RCM特征包括病灶区域边界清晰。MC,milia和KP都表现为囊肿样结构，它们的特点是囊性结构的位置和内容物的折射率。虽然副总裁,SK,JXG没有明显的囊样结构,VP的典型特征在于表皮中具有中等至高折射率的均匀分布的花瓣状结构。关于SK,特征是表皮明显增厚和鹅卵石状结构。JXG的主要特征是多个大的圆形和卵圆形细胞，具有泡沫状的细胞质，盘状多核大细胞在真皮中弥散分布。
结论：RCM可以实时可视化儿童常见面部丘疹皮肤病的主要关键诊断和区分特征，包括MC,米利亚,KP,VP,SK,和JXG。
BACKGROUND: Molluscum contagiosum (MC), milia, keratosis pilaris (KP), verruca plana (VP), seborrheic keratosis (SK), and juvenile xanthogranuloma (JXG) are common papule dermatoses on the face of children that have a similar appearance. In vivo evaluation of facial papule dermatoses with reflectance confocal microscopy (RCM) is helpful in the diagnosis of these ambiguous lesions in children. The purpose of this study was to clarify the RCM characteristics of MC, milia, KP, VP, SK, and JXG and explore the clinical application value of RCM for these common facial papule dermatoses.
METHODS: We recruited 113 patients referred for unequivocal facial papule dermatosis, including 21 patients with MC, 17 patients with milia, 19 patients with KP, 36 patients with VP, 8 patients with SK, and 12 patients with JXG. We evaluated the characteristics and distinguishing features of the six kinds of facial papule dermatoses using RCM.
RESULTS: The main RCM features of the six dermatoses included a well-demarcated border of the lesion area. MC, milia and KP all manifested cyst-like structures, and their distinguishing features were the location of the cystic structures and the refractive index of the contents. Although VP, SK, and JXG did not have obvious cystoid structures, VP was typically characterized by uniformly distributed petal-like structures with a medium-to-high refractive index in the epidermis. With regard to SK, the characteristic features were an obviously thickened epidermis and cobblestone-like structures. JXG was mainly characterized by multiple large round and ovoid cells with a foamy cytoplasm, and discoid-shaped multinucleated large cells were diffusely distributed in the dermis.
CONCLUSIONS: RCM allows the real-time visualization of major key diagnostic and distinguishing features of common facial papule dermatoses in children, including MC, milia, KP, VP, SK, and JXG.
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