体外培养节段型白癜风样无色素痣皮损黑素细胞及其临床意义

【摘要】 目的 评价负压吸疱表皮黑素细胞培养对节段型白癜风样无色素痣的辅助诊断价值。方法 收集2019年6月至2020年3月于杭州市第三人民医院皮肤科依据Coupe标准临床诊断的8例节段型白癜风样无色素痣患者，进行伍德灯、反射式共聚焦显微镜（RCM）检查，308 nm准分子激光试验，负压吸疱获取表皮黑素细胞并培养，记录结果。结果 8例患者中，6例皮损伍德灯下可见荧光，4例RCM下可见色素环完整性缺失，5例经308 nm准分子激光照射试验后未见复色反应。8例患者体外培养的皮损黑素细胞硫酸亚铁染色均阳性，经消化离心后沉淀呈黄白色，电镜下黑素细胞胞质内可见Ⅰ~ Ⅲ期黑素小体；皮损对侧同一解剖部位正常皮肤黑素细胞沉淀则呈黑色，电镜下黑素细胞胞质内可见Ⅰ~ Ⅳ期黑素小体。结论 负压吸疱表皮黑素细胞培养有助于诊断节段型白癜风样无色素痣。

In vitro culture of melanocytes from segmental vitiligo-like nevus depigmentosus lesions and its clinical significance

【Abstract】 Objective To assess the value of culture of epidermal melanocyte from negative-pressure suction blisters in the auxiliary diagnosis of segmental vitiligo-like nevus depigmentosus. Methods Between June 2019 and March 2020, 8 patients with segmental vitiligo-like nevus depigmentosus, who met the Coupe′s clinical diagnostic criteria, were enrolled from Department of Dermatology, Hangzhou Third People′s Hospital. All patients were evaluated by the Wood′s lamp, reflectance confocal microscopy （RCM）, 308-nm excimer laser radiation, and in vitro culture of epidermal melanocytes from negative-pressure suction blisters. Results Among the 8 patients, fluorescence was observed in 6 under the Wood′s lamp, dermal papillary rings were incomplete or absent in 4 as shown by RCM, and 5 experienced no repigmentation after 308-nm excimer laser radiation. Among the 8 patients, in vitro cultured lesional melanocytes all were positive for ferrous sulfate staining, yellowish-white precipitates were obtained after digestion and centrifugation of the melanocytes, and stageⅠ－Ⅲ melanosomes were observed in the cytoplasm of melanocytes under the electron microscope; however, the precipitates were black in color after digestion and centrifugation of the melanocytes collected from the normal skin tissues at the contralateral anatomical site, and stageⅠ－Ⅳ melanosomes were seen in the cytoplasm of the melanocytes under the electron microscope. Conclusion Culture of epidermal melanocytes from negative-pressure suction blisters may facilitates the diagnosis of segmental vitiligo-like nevus depigmentosus.