Kurzeja M, Czuwara J, Rakowska A, Sicińska J, Maj M, Nasierowska-Guttmejer A, Rudnicka L, Olszewska M
Department of Dermatology, CSK MSW, Warsaw, Poland.
Skin Res Technol. 2014 Nov;20(4):503-9. doi: 10.1111/srt.12146. Epub 2014 Feb 17.
BACKGROUND/PURPOSE: Reflectance confocal microscopy (RCM) is a non-invasive method for high-resolution, in vivo imaging of the epidermis and upper dermis. The purpose of the study was to evaluate the potential usefulness of RCM as a non-invasive diagnostic tool for Hailey-Hailey disease (familial benign chronic pemphigus).
Four patients with Hailey-Hailey disease were examined by RCM. Subsequently, punch biopsies were taken to compare RCM images with corresponding histopathologic findings.
On RCM images, the most sticking feature was acantholysis at the level of the granular and spinous layer, resembling a 'dilapidated brick wall'. We suggest the term 'dilapidated brick wall RCM sign' to describe this feature and to distinguish from the corresponding histopathology finding. Other RCM features included: epidermal disarray, intraepidermal clefts, inflammatory cells in the epidermis and in the superficial dermis. These RCM abnormalities correlated with analogous histopathology findings.
Reflectance confocal microscopy is a promising non-invasive diagnostic tool for Hailey-Hailey disease. The method may also be considered useful for choosing the best site for biopsy, which may aid pathology evaluation and spare time needed to establish the diagnosis.
背景/目的：反射共聚焦显微镜（RCM）是一种用于对表皮和真皮上层进行高分辨率活体成像的非侵入性方法。本研究的目的是评估RCM作为Hailey-Hailey病（家族性良性慢性天疱疮）非侵入性诊断工具的潜在实用性。
对4例Hailey-Hailey病患者进行了RCM检查。随后，进行了钻孔活检，以将RCM图像与相应的组织病理学结果进行比较。
在RCM图像上，最突出的特征是颗粒层和棘层水平的棘层松解，类似于“破败的砖墙”。我们建议用“破败砖墙RCM征”这一术语来描述这一特征，并与相应的组织病理学发现相区分。其他RCM特征包括：表皮紊乱、表皮内裂隙、表皮和浅表真皮中的炎症细胞。这些RCM异常与类似的组织病理学发现相关。
反射共聚焦显微镜是一种有前景的Hailey-Hailey病非侵入性诊断工具。该方法也可能有助于选择最佳活检部位，这可能有助于病理评估并节省确诊所需的时间。
