Hofmann-Wellenhof Rainer, Wurm Elisabeth M T, Ahlgrimm-Siess Verena, Richtig Erika, Koller Silvia, Smolle Josef, Gerger Armin
Department of Dermatology, Medical University of Graz, Graz, Austria.
Semin Cutan Med Surg. 2009 Sep;28(3):172-9. doi: 10.1016/j.sder.2009.06.004.
Reflectance confocal microscopy (RCM) enables in vivo imaging of human skin at a quasi histologic resolution. The black-and-white RCM images show horizontal sections of the skin, at a maximum depth of 350 microm. To date, the RCM features of a significant number of skin conditions have been described. The main focus of the research community investigating RCM, however, lies on describing and diagnosing melanocytic skin lesions. Taking into account all RCM studies dealing with diagnostic accuracy in melanocytic skin lesions, sensitivity and specificity of approximately 90% and 86% could be found. Improvement of diagnostic accuracy, improved assessment of dermoscopic-histologic correlation, in vivo biopsy side selection, surgical margin assessment, and response control of conservative therapies in skin diseases are some of the major advantages of this novel imaging method. Additionally, RCM holds inherent potential for teledermatologic application and automated image analyzing. This article describes morphologic features of diverse skin lesions and features of "normal skin," summarizes diagnostic advances of RCM, compares studies dealing with diagnostic applicability, and discusses further research goals of this exciting new imaging technique.
反射式共聚焦显微镜（RCM）能够以准组织学分辨率对人体皮肤进行体内成像。黑白RCM图像显示皮肤的水平切片，最大深度为350微米。迄今为止，已经描述了大量皮肤疾病的RCM特征。然而，研究RCM的科学界的主要重点在于描述和诊断黑素细胞性皮肤病变。考虑到所有涉及黑素细胞性皮肤病变诊断准确性的RCM研究，其敏感性和特异性分别约为90%和86%。提高诊断准确性、改善皮肤镜-组织学相关性评估、体内活检部位选择、手术切缘评估以及皮肤病保守治疗的反应控制是这种新型成像方法的一些主要优点。此外，RCM在远程皮肤病学应用和自动图像分析方面具有内在潜力。本文描述了各种皮肤病变的形态学特征和“正常皮肤”的特征，总结了RCM的诊断进展，比较了涉及诊断适用性的研究，并讨论了这种令人兴奋的新成像技术的进一步研究目标。
