González S, Sánchez V, González-Rodríguez A, Parrado C, Ullrich M
Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, EE. UU.; Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, España.
Servicio de Dermatología, Hospital Universitario Madrid Sanchinarro, Universidad CEU San Pablo, Madrid, España.
Actas Dermosifiliogr. 2014 Jun;105(5):446-58. doi: 10.1016/j.ad.2013.03.010. Epub 2013 Sep 1.
Reflectance confocal microscopy is currently the most promising noninvasive diagnostic tool for studying cutaneous structures between the stratum corneum and the superficial reticular dermis. This tool gives real-time images parallel to the skin surface; the microscopic resolution is similar to that of conventional histology. Numerous studies have identified the main confocal features of various inflammatory skin diseases and tumors, demonstrating the good correlation of these features with certain dermatoscopic patterns and histologic findings. Confocal patterns and diagnostic algorithms have been shown to have high sensitivity and specificity in melanoma and nonmelanoma skin cancer. Possible present and future applications of this noninvasive technology are wide ranging and reach beyond its use in noninvasive diagnosis. This tool can also be used, for example, to evaluate dynamic skin processes that occur after UV exposure or to assess tumor response to noninvasive treatments such as photodynamic therapy. We explain the characteristic confocal features found in the main nonmelanoma skin tumors and discuss possible applications for this novel diagnostic technique in routine dermatology practice.
反射式共聚焦显微镜是目前用于研究角质层与浅表网状真皮之间皮肤结构的最具前景的非侵入性诊断工具。该工具可提供与皮肤表面平行的实时图像；微观分辨率与传统组织学相似。大量研究已确定了各种炎症性皮肤病和肿瘤的主要共聚焦特征，证明了这些特征与某些皮肤镜模式和组织学发现具有良好的相关性。共聚焦模式和诊断算法已被证明在黑色素瘤和非黑色素瘤皮肤癌中具有高敏感性和特异性。这种非侵入性技术目前和未来可能的应用范围广泛，超出了其在非侵入性诊断中的应用。例如，该工具还可用于评估紫外线照射后发生的动态皮肤过程，或评估肿瘤对光动力疗法等非侵入性治疗的反应。我们解释了主要非黑色素瘤皮肤肿瘤中发现的特征性共聚焦特征，并讨论了这种新型诊断技术在常规皮肤科实践中的可能应用。
