背景:认识朗格汉斯细胞组织细胞增生症(LCH)由于其稀有性,可能是一个挑战。反射共聚焦显微镜(RCM)和皮肤镜检查是新兴的有希望的非侵入性技术,可作为诊断不同皮肤状况的辅助工具。然而,LCH的RCM和皮肤镜特征研究较少。揭示LCH的常见RCM和皮肤特征。
方法:40例LCH患者按年龄进行回顾性分析,地点,临床,RCM,和2016年9月至2022年12月的皮肤镜特征。为了揭示临床上的差异和共性,RCM,和不同解剖位置的皮肤镜特征。
结果:在研究中,好发部位包括主干31/40(77.5%),四肢21/40(52.5%),脸14/40(35%),头皮11/40(27.5%),外阴4/40(10%),和指甲2/40(5%)。所有LCH都具有共同的RCM功能。年龄和病变解剖部位的临床和皮肤镜特征存在显着差异。头皮的常见皮肤镜特征,脸,树干,四肢是红斑鳞屑样皮疹,紫红色小球或斑块,疤痕状条纹具扩张血管。虽然指甲LCH的特征是紫癜纹,糜烂和脓性鳞屑,外阴LCH的糜烂性红斑和脓性鳞屑。所有LCH的共同RCM特征在表面角蛋白层中显示出焦点高反射致密图像,表皮建筑混乱,真皮-表皮交界处的模糊,众多的多边形,大,中等反射,表皮中的短树突细胞,和真皮。所有累及外阴和指甲的LCH均未出现皮肤病变。
结论:RCM和皮肤镜检查对LCH的诊断和鉴别诊断具有良好的价值。
BACKGROUND: Recognizing Langerhans cell histiocytosis (LCH) might be a challenge due to its rarity. Reflectance confocal microscopy (RCM) and dermoscopy were emergent promising non-invasive technique as auxiliary tools in diagnosis of different skin conditions. However, the RCM and dermoscopic features of LCH had been less investigated. To reveal the common RCM and dermoscopic features of LCH.
METHODS: Forty cases of LCH were retrospectively analyzed according to age, locations, clinical, RCM, and dermoscopic features from September 2016 to December 2022. To reveal the differences and common in clinical, RCM, and dermoscopic features that occur in different anatomic location.
RESULTS: In the study, sites of predilection include the trunk 31/40 (77.5%), extremity 21/40 (52.5%), face 14/40 (35%), scalp 11/40 (27.5%), vulvar 4/40 (10%), and nail 2/40 (5%). All LCHs had the common RCM features. There were significant differences in clinical and dermoscopic features for age and lesion anatomic site. The common dermoscopic features for scalp, face, trunk, and extremity were the erythematous scaly rash, purplish-red globules or patches, scar-like streaks with ectatic vessels. While the features for nail LCH were purpuric striae, onycholysis and purulent scaly rash, and the erosive erythematous plaque and purulent scaly rash for vulvar LCH. The common RCM features of all LCH showed a focal highly reflective dense image in the surface keratin layer, epidermis architectural disarray, obscuration of dermo-epidermal junction, numerous polygonal, large, medium reflective, short dendrites cells in the epidermis, and dermis. All LCH involving the vulvar and nail did not manifest skin lesions.
CONCLUSIONS: RCM and dermoscopy showed promising value for diagnosis and differentiation of LCH.