Ahlgrimm-Siess V, Massone C, Koller S, Fink-Puches R, Richtig E, Wolf I, Gerger A, Hofmann-Wellenhof R
Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, 8036 Graz, Austria.
Br J Dermatol. 2008 May;158(5):1000-7. doi: 10.1111/j.1365-2133.2008.08460.x. Epub 2008 Feb 18.
A systematic examination and comparison of confocal scanning laser microscopy (CSLM) features of benign naevi showing different dermoscopic patterns has never been performed.
Systematically to assess CSLM features of dermoscopically benign reticular, globular and homogeneous naevi and to correlate CSLM findings with dermoscopy and histopathology.
CSLM was performed on 30 naevi in 29 patients including 10 reticular, 10 globular and 10 homogeneous naevi showing a uniform pigmentation pattern with dermoscopy. Cytomorphological and architectural features of each naevus were assessed and distinct characteristics for each group of naevi were defined. CSLM features were correlated with the histopathological findings and their applicability for the diagnosis of naevi with different dermoscopic patterns was assessed by two blinded observers.
A correct diagnosis was made in 26 and 28 of 30 cases, respectively, by two blinded observers using previously defined CSLM features. Well-defined melanocytic caps, well-defined edged papillae and black papillae concurrently with the absence of white papillae were found in all reticular naevi (10 of 10). Numerous, large junctional/dermal melanocytic nests (10 of 10), ill-defined edged papillae (eight of 10) and white papillae (nine of 10) were found in globular naevi. Homogeneous naevi showed an intermediate pattern between reticular and globular naevi: ill-defined edged papillae (10 of 10), black and white papillae within the same naevus (eight of 10) and junctional/dermal melanocytic nests (three of 10) were seen.
Different dermoscopic patterns of benign naevi are reflected in different architectural features in CSLM. As benign naevi show a regular architecture of monomorphous melanocytes in contrast to melanomas, similar dermoscopic features of naevi and early melanomas may be differentiated by CSLM.
从未对显示不同皮肤镜模式的良性痣的共聚焦扫描激光显微镜（CSLM）特征进行过系统的检查和比较。
系统评估皮肤镜下良性网状、球状和均匀性痣的CSLM特征，并将CSLM结果与皮肤镜检查和组织病理学相关联。
对29例患者的30颗痣进行CSLM检查，其中包括10颗网状痣、10颗球状痣和10颗均匀性痣，这些痣在皮肤镜检查中显示出均匀的色素沉着模式。评估每颗痣的细胞形态学和结构特征，并确定每组痣的独特特征。将CSLM特征与组织病理学结果相关联，并由两名盲法观察者评估其对不同皮肤镜模式痣诊断的适用性。
两名盲法观察者分别使用先前定义的CSLM特征，在30例病例中的26例和28例中做出了正确诊断。在所有网状痣（10颗中的10颗）中均发现了界限清晰的黑素细胞帽、界限清晰的边缘乳头和黑色乳头，同时不存在白色乳头。在球状痣中发现了大量、大的交界性/真皮黑素细胞巢（10颗中的10颗）、界限不清的边缘乳头（10颗中的8颗）和白色乳头（10颗中的9颗）。均匀性痣显示出介于网状痣和球状痣之间 的中间模式：界限不清的边缘乳头（10颗中的10颗）、同一颗痣内的黑色和白色乳头（10颗中的8颗）以及交界性/真皮黑素细胞巢（10颗中的3颗）。
良性痣的不同皮肤镜模式在CSLM的不同结构特征中得到反映。由于良性痣与黑色素瘤相比显示出单形性黑素细胞的规则结构，因此痣和早期黑色素瘤的相似皮肤镜特征可通过CSLM进行区分。
