Department of Dermatology and Allergology, Augsburg Medical Center, Augsburg, Germany.
J Dtsch Dermatol Ges. 2017 Oct;15(10):999-1016. doi: 10.1111/ddg.13347.
In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy allows for high-resolution imaging of the epidermis and upper dermis. It is particularly suitable in the differential diagnosis of melanocytic lesions. Optical coherence tomography (OCT) has a lower resolution compared to confocal laser microscopy but a greater depth of penetration. It is primarily used for imaging epithelial skin cancer, especially in the context of monitoring the effectiveness of nonsurgical therapies. Electrical impedance spectroscopy does not yield cutaneous images but rather provides a score based on the cellular irregularity of the skin. Multispectral analysis involves illumination of the skin with different wavelengths and likewise results in the computation of a score. Both methods are used in the differentiation of dysplastic nevi from melanoma. Other diagnostic imaging and biophysical methods are currently still in the developmental stages. By increasing the sensitivity and specificity of clinical and dermoscopic findings, the aforementioned methods bring about an improvement in noninvasive diagnosis. They allow for skin lesions to be monitored over time and therapeutic effects to be quantified. Finally, they facilitate early diagnosis of skin cancer, and help avoid unnecessary surgery of benign lesions.
除了皮肤镜检查，还有其他用于非侵入性诊断皮肤病变的成像和生物物理方法。共聚焦激光显微镜允许对表皮和上部真皮进行高分辨率成像。它特别适用于黑素细胞病变的鉴别诊断。与共聚焦激光显微镜相比，光学相干断层扫描（OCT）的分辨率较低，但穿透深度更大。它主要用于成像上皮性皮肤癌，特别是在监测非手术治疗效果的情况下。皮肤电阻抗谱不产生皮肤图像，而是根据皮肤细胞的不规则性提供一个评分。多光谱分析涉及用不同波长照射皮肤，同样也会计算出一个评分。这两种方法都用于区分发育不良痣和黑色素瘤。其他诊断成像和生物物理方法目前仍处于发展阶段。通过提高临床和皮肤镜检查结果的敏感性和特异性，上述方法可改善非侵入性诊断。它们可以随时间监测皮肤病变，并量化治疗效果。最后，它们有助于早期诊断皮肤癌，并有助于避免对良性病变进行不必要的手术。
