Wang L, Xu A-E
Department of Dermatology, Affiliated Hangzhou Clinical College, Anhui Medical University, Hangzhou, China.
J Eur Acad Dermatol Venereol. 2014 Sep;28(9):1199-206. doi: 10.1111/jdv.12264. Epub 2013 Sep 7.
Riehl's melanosis often poses a diagnostic challenge because of the variability in clinical morphology. Reflectance confocal microscopy (RCM), similar to dermoscopy, images lesions in an en face plane, thus enabling direct correlations with dermoscopic images. No published data are currently available regarding dermoscopic and RCM findings in Riehl's melanosis.
The aim of our study was to correlate the features of Riehl's melanosis across various imaging modalities including dermoscopy, confocal microscopy and histopathological examination to give a more precise description of this disease to improve the accuracy of diagnosis.
Fifteen patients with a previously established diagnosis of Riehl's melanosis were recruited. All lesions were imaged using dermoscope and in vivo RCM, followed by complete excision for histopathological analysis.
A series of dermoscopic and RCM features of Riehl's melanosis were identified and shown to correlate well with histopathological examination. Pseudonetworks, grey dots/granules, liquefaction of basal cells, incontinence of pigment were the most distinctive characteristic.
This study highlights the clinical, dermoscopic, confocal microscopic and histopathological features of Riehl's melanosis. It is necessary to further define the diagnostic features of clinically difficult lesions with these modalities, but clinical evaluation should not be neglected.
由于临床形态的变异性，里尔黑变病常常带来诊断挑战。反射式共聚焦显微镜检查（RCM）与皮肤镜类似，在正位平面成像病变，从而能够与皮肤镜图像直接关联。目前尚无关于里尔黑变病的皮肤镜和RCM表现的已发表数据。
我们研究的目的是关联里尔黑变病在包括皮肤镜、共聚焦显微镜检查和组织病理学检查等各种成像方式下的特征，以便更精确地描述这种疾病，提高诊断准确性。
招募了15例先前已确诊为里尔黑变病的患者。所有病变均使用皮肤镜和活体RCM成像，随后完整切除进行组织病理学分析。
确定了一系列里尔黑变病的皮肤镜和RCM特征，并显示与组织病理学检查相关性良好。假网状结构、灰色小点/颗粒、基底细胞液化、色素失禁是最具特征性的表现。
本研究突出了里尔黑变病的临床、皮肤镜、共聚焦显微镜和组织病理学特征。有必要用这些方式进一步明确临床疑难病变的诊断特征，但临床评估不应被忽视。
