反射式共聚焦显微镜联合皮肤镜在瑞尔黑变病诊断中的应用

目的探讨瑞尔黑变病在反射式共聚焦扫描显微镜(RCM)和皮肤镜下的主要敏感图像特征。方法招募7例经病理确诊为瑞尔黑变病的患者,所有患者均经RCM和皮肤镜成像,记录并分析图像特征。结果皮损处RCM主要敏感图像特征:真表皮交界处模糊不清,基底细胞环不完整。真表皮交界处、真皮乳头处数量不等的形状不规则的高折光细胞,散在中等折光类圆形细胞浸润。毛囊口扩张、其内见弱折光物质。皮损处皮肤镜主要敏感图像特征:假网状结构、灰色点状颗粒结构、毛囊周围白晕、毛囊角栓、毛细血管扩张是瑞尔黑变病最显著的特征。结论RCM和皮肤镜可作为瑞尔黑变病的无创诊断手段。

Application of the Reflectance Confocal Microscopy Combined with Dermoscopy in the Diagnosis of Melanosis

Objective In order to investigate the main sensitive image features of melanosis under reflectance confocal microscopy(RCM)and dermoscopy.Methods Seven cases of Riehl's melanosis diagnosed by pathology were recruited.All patients were examined by RCM and dermoscopy.The image characteristics were recorded and analyzed.Results The main sensitive image features of lesions by RCM.The dermoepidermal junction was blurred and the basal cell ring was incomplete.The number of irregular high refractive cells and moderate refractive round cells scattered in dermoepidermal junction and dermal papillae.The follicular orifice was dilated with weak refractive substances.The main sensitive image features of lesions by dermatoscopy:pseudonetwork,grey dots/granules,perifollicular whitish halo,follicular horn embolus and capillary dilatation were the most prominent features of Riehl's melanosis.Conclusion RCM and dermoscopy can be used as noninvasive diagnostic methods for Riehl's melanosis.