肢端雀斑样黑素瘤的共聚焦激光扫描显微镜特征：与肢端痣的对比研究。
Reflectance confocal microscopy features of acral lentiginous melanoma: a comparative study with acral nevi.
机构信息
Dermatology Department, CHU of Saint-Etienne, Saint Etienne, France.
Dermatology Department, Hospices Civils of Lyon, Lyon, France.
出版信息
J Eur Acad Dermatol Venereol. 2016 Jul;30(7):1125-8. doi: 10.1111/jdv.13399. Epub 2015 Oct 1.
BACKGROUND
Acral lentiginous melanoma (ALM) can be difficult to differentiate from acral nevus. Reflectance confocal microscopy (RCM) is widely used for the diagnosis of melanocytic tumours, but the RCM features of ALM and acral nevus have not been described yet.
OBJECTIVE
To determine the RCM features of ALM and acral nevus, and their correlation with clinical and histological characteristics.
METHODS
Retrospective study of 17 cases of ALM and 26 acral nevi.
RESULTS
Pagetoid cells were present in all ALMs with a visible epidermis and in three nevi. A proliferation of atypical melanocytes at the dermal-epidermal junction (DEJ) and/or in the dermis was visible in nine ALMs but not in nevi. The histopathological examination of initial skin biopsies was unable to diagnose ALM in four cases, differing from RCM that could identify malignant tumour cells by exploring the whole lesions.
CONCLUSION
Reflectance confocal microscopy can help in the differentiation of ALM and acral nevus, and to guide the biopsy.
背景
肢端雀斑样黑素瘤（ALM）很难与肢端痣区分。反射共聚焦显微镜（RCM）广泛用于诊断黑素细胞肿瘤，但尚未描述 ALM 和肢端痣的 RCM 特征。
目的
确定 ALM 和肢端痣的 RCM 特征及其与临床和组织学特征的相关性。
方法
回顾性研究 17 例 ALM 和 26 例肢端痣。
结果
所有可见表皮的 ALM 和 3 例痣中均存在派杰样细胞。在 9 例 ALM 中可见到不典型黑素细胞在真皮-表皮交界处（DEJ）和/或真皮中的增殖，但在痣中未见。4 例初始皮肤活检的组织病理学检查无法诊断 ALM，而 RCM 可以通过探查整个病变来识别恶性肿瘤细胞。
结论
反射共聚焦显微镜有助于区分 ALM 和肢端痣，并指导活检。
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