Hospital das Clínicas of São Paulo University, São Paulo, Brazil.
Hospital das Clínicas of São Paulo University, São Paulo, Brazil.
J Am Acad Dermatol. 2020 Dec;83(6):1668-1673. doi: 10.1016/j.jaad.2019.12.018. Epub 2019 Dec 14.
Xeroderma pigmentosum (XP) is a rare genetic disease characterized by extreme photosensitivity, resulting in a higher incidence of cutaneous tumors. Reflectance confocal microscopy (RCM) is a noninvasive imaging method for diagnosing cutaneous lesions.
To explore the application of RCM in the follow-up of patients with XP.
Patients with XP underwent RCM for suspicious lesions from January 2010 through April 2019. Lesions with malignant RCM features were excised, and the results were compared with their histopathologic features. Benign lesions on RCM were monitored every 3 months. We recorded the confocal features that were related to malignancy and specifically to melanoma.
A total of 61 suspicious lesions from 13 patients with XP were included. Thirty-three lesions (54%) were malignant (14 melanomas, 15 basal cell carcinomas, and 4 squamous cell carcinomas). Nonvisible papillae (OR, 11.8; 95% CI, 2.6-53.1; P = .001) and atypical cells at the dermoepidermal junction (OR, 11.7; 95% CI, 2.7-50.3; P = .001) were independent predictors of malignancy.
There were limited numbers of patients and lesions. Most cases were retrospectively included, and some did not have a histologic analysis.
RCM is a valuable tool in the follow-up of patients with XP, reducing the need for excisions by 35%.
着色性干皮病（XP）是一种罕见的遗传性疾病，其特征为极度光敏感，导致皮肤肿瘤的发病率较高。反射共聚焦显微镜（RCM）是一种用于诊断皮肤病变的非侵入性成像方法。
探讨 RCM 在 XP 患者随访中的应用。
2010 年 1 月至 2019 年 4 月，对疑似 XP 患者的病变进行 RCM 检查。对具有恶性 RCM 特征的病变进行切除，并将结果与组织病理学特征进行比较。对 RCM 上的良性病变每 3 个月监测一次。我们记录了与恶性病变特别是黑色素瘤相关的共聚焦特征。
共纳入 13 例 XP 患者的 61 个可疑病变。33 个病变（54%）为恶性（14 个黑色素瘤、15 个基底细胞癌和 4 个鳞状细胞癌）。不可见的乳头（OR，11.8；95%CI，2.6-53.1；P =.001）和表皮下交界区的不典型细胞（OR，11.7；95%CI，2.7-50.3；P =.001）是恶性的独立预测因子。
患者和病变数量有限。大多数病例为回顾性纳入，部分病例未行组织学分析。
RCM 是 XP 患者随访的一种有价值的工具，可将切除率降低 35%。
