Department of Restorative Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Eur J Dermatol. 2010 Nov-Dec;20(6):705-11. doi: 10.1684/ejd.2010.1061. Epub 2010 Sep 7.
Few studies have reported on the accuracy of reflectance confocal laser microscopy (RCLM) in observing allergic contact dermatitis in vivo. However, distinction of skin reactions from different reagents is not well understood. We sought to diagnose allergic contact dermatitis by RCLM images and compare with routine, visual patch test (PT) reading for 2 major allergen metals in Japan. The PT was performed on the upper back skin with 5% nickel sulfate (Ni) and 2% cobalt chloride (Co) in eight healthy volunteers and eleven patients. RCLM was used to calculate the thickness of the suprabasal epidermis after visual assessment of PT. Comparison of clinical scoring versus suprabasal epidermal thickness was observed. RCLM images of positive PT showed increased suprabasal epidermal thickness on day 2 (D2), and D3 for Co, whereas there was vesicle formation and an overall increase suprabasal epidermal thickness for Ni. In two of 3 doubtful positive PT to Co, RCLM images presented characteristics of irritant reactions; and one characteristic of a positive reaction. The frequency of Co doubtful-positive PT was higher than that of Ni. We found advantages in using RCLM for visualizing features of allergic contact dermatitis and found it a useful tool as an objective parameter in grading severity and types of PT reaction.
目前，鲜有研究报道反射共聚焦激光显微镜（RCLM）在活体观察变应性接触性皮炎方面的准确性。然而，不同试剂引起的皮肤反应尚不清楚。我们试图通过 RCLM 图像来诊断变应性接触性皮炎，并与日本两种主要变应原金属的常规视觉斑贴试验（PT）结果进行比较。在 8 名健康志愿者和 11 名患者的背部上侧皮肤进行 5%硫酸镍（Ni）和 2%氯化钴（Co）的 PT。PT 后，通过视觉评估 RCLM 来计算棘层上部表皮的厚度。观察临床评分与棘层上部表皮厚度的比较。阳性 PT 的 RCLM 图像显示 Co 在 D2 和 D3 时棘层上部表皮厚度增加，而 Ni 则出现水疱形成和棘层上部表皮厚度整体增加。在 3 例 Co 可疑阳性 PT 中，有 2 例 RCLM 图像呈现出刺激性反应的特征；有 1 例呈现阳性反应的特征。Co 可疑阳性 PT 的频率高于 Ni。我们发现 RCLM 有助于观察变应性接触性皮炎的特征，并且作为 PT 反应严重程度和类型的客观参数非常有用。
