背景:在临床上,常见的面部丘疹皮肤病,如脂溢性角化病(SK),扁平疣(VP),汗管瘤和扁平苔藓(LN)常被误诊。总结面部丘疹皮肤病的体内反射共聚焦显微镜(RCM)特征有助于诊断模糊病变。这项研究的目的是评估SK的特征,VP,汗管瘤,和RCM中的LN。
方法:我们招募了144名明确的面部丘疹性皮肤病患者,其中包括60名SK患者,60例VP患者,10例汗管瘤患者,和14名LN患者。在表皮评估RCM图像,皮肤表皮交界处,以及丘疹皮损和正常皮肤的真皮。
结果:在表皮中,大脑形态是SK的主要RCM特征,“花瓣样”结构是VP的主要RCM特征。在表皮真皮交界处,我们发现的RCM功能如下:对于SK,明亮的真皮乳头状环,在异常的真皮乳头处也观察到异常的真皮乳头和环状血管。对于VP,在圆形真皮乳头处也观察到明亮的真皮乳头状环和点状血管。对于LN,圆,放大,界限清楚的真皮乳头和增大的真皮乳头充满了单个高屈光细胞。在真皮中,RCM检查显示明亮的折射性致畸汗管,在所有汗管瘤患者中设计各种可见的明亮的“月亮”结构。
结论:考虑到我们的结果,RCM可能有助于非侵入性区分SK,VP,体内汗管瘤和LN。
BACKGROUND: In clinical, common facial papule dermatosis such as seborrheic keratosis (SK), verruca plana (VP),
syringoma and lichen nitidus (LN) is often misdiagnosed. Summarizing in vivo reflectance confocal microscopy (RCM) features of the facial papule dermatosis is helpful in the diagnosis of ambiguous lesions. The purpose of this study was to evaluate the features of SK, VP,
syringoma, and LN in RCM.
METHODS: We recruited 144 patients referred for unequivocal facial papule dermatosis including 60 patients with SK, 60 patients with VP, 10 patients with
syringoma, and 14 patients with LN. The RCM images were evaluated at the epidermis, the dermoepidermal junction, and the dermis from both papule lesions and normal skin.
RESULTS: In the epidermis, the cerebriform shape was the main RCM characteristic of SK and the \"petal-like\" structure was the main RCM characteristic of VP. In the dermoepidermal junction, the RCM features we found were as follows: For SK, the bright dermal papillary rings, the abnormal dermal papilla and the looped vessels were also observed at the abnormal dermal papilla. For VP, the bright dermal papillary rings and the point-like blood vessels were also observed at the round dermal papills. For LN, the round, enlarged, well-circumscribed dermal papillae and the enlarged dermal papillaes were heavily laden with individual highly refractive cells. In the dermis, RCM examination revealed brightly refractile teratogenous sweat tube, designing variably visible bright \"moon\" structures in all
syringoma patients.
CONCLUSIONS: Considering our results, RCM may be useful to non-invasively discriminate SK, VP,
syringoma and LN in vivo.