反射式共聚焦显微镜可在体内鉴别急性过敏性和刺激性接触性皮炎。
Reflectance confocal microscopy may differentiate acute allergic and irritant contact dermatitis in vivo.
作者信息
Swindells Kirsty, Burnett Nadine, Rius-Diaz Francisca, González Ernesto, Mihm Martin C, González Salvador
机构信息
Wellman Laboratories of Photomedicine, Massachusetts Geneeral Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
出版信息
J Am Acad Dermatol. 2004 Feb;50(2):220-8. doi: 10.1016/j.jaad.2003.08.005.
BACKGROUND
Acute irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD) may be difficult to distinguish by clinical or histologic assessment. Reflectance confocal microscopy (RCM) enables real-time, high-resolution skin imaging in vivo.
OBJECTIVE
We sought to image, characterize, and distinguish acute ACD and ICD in vivo.
METHODS
Volunteers with ACD were patch tested with an allergen and the irritant, sodium lauryl sulfate. RCM imaging and transepidermal water loss measurements were performed at 24 and 72 hours. Biopsy specimens were correlated with RCM images.
RESULTS
Spongiosis, epidermal inflammatory cell infiltrate, and vesicle formation were observed in ACD and ICD. Compared with ACD, ICD showed greater disruption of the stratum corneum, and more parakeratosis. There was a significantly greater increase in transepidermal water loss for ICD compared with ACD.
CONCLUSION
RCM is a promising tool for dynamic, noninvasive assessment and may help to differentiate acute ACD and sodium lauryl sulfate-induced ICD.
背景
急性刺激性接触性皮炎（ICD）和过敏性接触性皮炎（ACD）可能难以通过临床或组织学评估来区分。反射共聚焦显微镜（RCM）能够在体内进行实时、高分辨率的皮肤成像。
目的
我们试图在体内对急性ACD和ICD进行成像、表征并加以区分。
方法
对患有ACD的志愿者进行变应原和刺激性物质月桂醇硫酸酯钠的斑贴试验。在24小时和72小时时进行RCM成像和经表皮水分流失测量。活检标本与RCM图像相关联。
结果
在ACD和ICD中均观察到海绵形成、表皮炎性细胞浸润和水疱形成。与ACD相比，ICD显示角质层破坏更严重，角化不全更多。与ACD相比，ICD的经表皮水分流失增加明显更多。
结论
RCM是一种用于动态、无创评估的有前景的工具，可能有助于区分急性ACD和月桂醇硫酸酯钠诱导的ICD。
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