Gamo R, Pampín A, Floristán U
Hospital Universitario Fundación de Alcorcón, Madrid, España.
Hospital Universitario Fundación de Alcorcón, Madrid, España.
Actas Dermosifiliogr. 2016 Dec;107(10):830-835. doi: 10.1016/j.ad.2016.07.012. Epub 2016 Sep 7.
Lentigo maligna is the most common type of facial melanoma. Diagnosis is complicated, however, as it shares clinical and dermoscopic characteristics with other cutaneous lesions of the face. Reflectance confocal microscopy is an imaging technique that permits the visualization of characteristic features of lentigo maligna. These include a disrupted honeycomb pattern and pagetoid cells with a tendency to show folliculotropism. These cells typically have a dendritic morphology, although they may also appear as round cells measuring over 20μm with atypical nuclei. Poorly defined dermal papillae and atypical cells may be seen at the dermal-epidermal junction and can form bridges resembling mitochondrial structures. Other characteristic findings include junctional swelling with atypical cells located around the follicles, resembling caput medusae. Reflectance confocal microscopy is a very useful tool for diagnosing lentigo maligna.
恶性雀斑样痣是面部黑色素瘤最常见的类型。然而，由于它与面部其他皮肤病变具有共同的临床和皮肤镜特征，诊断较为复杂。反射式共聚焦显微镜是一种成像技术，可使恶性雀斑样痣的特征性表现可视化。这些表现包括蜂窝状结构破坏以及具有向毛囊性生长倾向的派杰样细胞。这些细胞通常具有树突状形态，尽管它们也可能表现为直径超过20μm且具有非典型核的圆形细胞。在真皮 - 表皮交界处可见定义不清的真皮乳头和非典型细胞，并且可形成类似线粒体结构的桥。其他特征性表现包括毛囊周围有非典型细胞的交界性肿胀，类似水母头。反射式共聚焦显微镜是诊断恶性雀斑样痣的非常有用的工具。
