San Gallicano Dermatological Institute, Rome, Italy.
Skin Res Technol. 2014 May;20(2):194-9. doi: 10.1111/srt.12105. Epub 2013 Aug 28.
Bullous pemphigoid is an autoimmune disease affecting prevalently the elder. In vivo reflectance confocal microscopy is a non-invasive technique for real-time imaging of the skin with cellular-level resolution. No previous data has been reported about confocal microscopy of bullous pemphigoid. Aim of this preliminary study is the evaluation of the potential of in vivo reflectance confocal microscopy for real-time, microscopical confirmation of clinical bullous pemphigoid diagnosis.
A total of nine lesions from patients affected by pemphigoid underwent in vivo reflectance confocal microscopy before histological examination.
In our preliminary study, confocal microscopy showed high grade of correspondence to histopathology. In particular, presence of sub-epidermal cleft and variable amount of oedema of the upper dermis associated with inflammatory cells infiltration were seen as prevalent confocal features in the bullous lesions considered. Differently, in urticarial lesions, no specific features could be appreciated at confocal analysis beside the presence of signs of spongiosis and perivascular inflammation.
Confocal microscopy seems to be useful for in vivo, microscopical confirmation of the clinical suspect of bullous pemphigoid and for biopsy site selection in urticarial lesions to obtain a more significant specimen for histopathological examination.
大疱性类天疱疮是一种主要影响老年人的自身免疫性疾病。体内共聚焦激光扫描显微镜是一种实时、非侵入性的皮肤成像技术，具有细胞水平的分辨率。目前尚无关于大疱性类天疱疮共聚焦显微镜的报道。本初步研究的目的是评估体内共聚焦激光扫描显微镜在实时、微观确认临床大疱性类天疱疮诊断方面的潜力。
共对 9 例大疱性类天疱疮患者的皮损进行了体内共聚焦激光扫描显微镜检查，然后进行组织学检查。
在我们的初步研究中，共聚焦显微镜显示出与组织病理学高度一致的结果。特别是，在考虑的大疱性病变中，可见表皮下裂隙和不同程度的真皮水肿，伴有炎症细胞浸润，这是共聚焦的主要特征。相反，在荨麻疹性病变中，除了存在海绵形成和血管周围炎症的迹象外，共聚焦分析中没有发现特定的特征。
共聚焦显微镜可用于实时、微观确认大疱性类天疱疮的临床疑似病例，并可用于荨麻疹性病变活检部位的选择，以获得更有意义的组织病理学检查标本。
