Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Science, Jinan, Shandong, China.
Skin Res Technol. 2010 Nov;16(4):408-12. doi: 10.1111/j.1600-0846.2010.00444.x.
Differentiation of some seborrheic keratosis (SK) and verruca plana (VP) lesions is a challenge. Confocal laser scanning microscopy (CLSM) has been proved to be useful in the diagnosis of skin diseases; however, to date, there is no report on the differential study of the two diseases with CLSM.
To obtain the CLSM image characteristics of SK and VP, and then test the differential ability of CLSM imaging.
We recruited 10 patients with typical lesions of SK under CLSM images to validate the features reported. Another 10 patients with typical VP lesions were also recruited, imaged with CLSM and biopsied to obtain the features under CLSM images based on histology analysis. Then, we attempt to summarize and refine those characteristics collected to obtain the most significant ones. All the cases with lesions suggestive of SK or VP were advised to undergo imaging with CLSM, and if CLSM imaging reflected discordantly with the clinical diagnosis, a biopsy was suggested for the exact lesion imaged. Those cases with CLSM and histology results were collected. Finally, two clinical dermatologists, who had no previous experience with CLSM, were tested with the simplified features of CLSM images to differentiate the suspected lesions of SK and VP among the cases collected.
In total, there were 58 cases with CLSM images and histology results collected, in which, 40 cases were diagnosed as SK and 18 cases as VP by histology. The two blinded dermatologists' judgments were identical to histology analysis.
CLSM proved to be valuable in the differential diagnosis of SK and VP. The simplified characteristics were easily understood and acceptable to those with no previous experience of CLSM.
一些脂溢性角化病（SK）和扁平疣（VP）病变的鉴别具有一定挑战性。共聚焦激光扫描显微镜（CLSM）已被证明在皮肤病的诊断中具有一定价值；然而，迄今为止，尚无关于 CLSM 对这两种疾病进行鉴别研究的报道。
获取 SK 和 VP 的 CLSM 图像特征，并检验 CLSM 成像的鉴别能力。
我们招募了 10 例具有典型 SK 病变的患者，通过 CLSM 图像验证已报道的特征。另外还招募了 10 例具有典型 VP 病变的患者，对其进行 CLSM 成像并进行活检，以根据组织学分析获得 CLSM 图像下的特征。然后，我们尝试总结和提炼这些收集到的特征，以获得最显著的特征。所有疑似 SK 或 VP 病变的患者均建议进行 CLSM 成像，如果 CLSM 图像与临床诊断不一致，则建议对所成像的准确病变进行活检。对具有 CLSM 和组织学结果的病例进行了收集。最后，对两位以前没有 CLSM 经验的临床皮肤科医生进行了测试，他们根据简化的 CLSM 图像特征来区分收集的疑似 SK 和 VP 病变。
共收集到 58 例具有 CLSM 图像和组织学结果的病例，其中 40 例经组织学诊断为 SK，18 例为 VP。两位盲法皮肤科医生的判断与组织学分析结果一致。
CLSM 对 SK 和 VP 的鉴别诊断具有一定价值。简化后的特征易于理解，对于没有 CLSM 经验的人来说也是可以接受的。
