Department of Skin and Cosmetic Research, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China.
Department of Dermatopathology, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China.
Skin Res Technol. 2020 Sep;26(5):671-674. doi: 10.1111/srt.12851. Epub 2020 Mar 16.
The updated standard classification and pathophysiology of rosacea have provided clear and meaningful evaluation parameters; however, differentiating rosacea from sensitive skin (SS) remained an obstacle for dermatologists around the world, especially in China. Herein, we aimed to find a better characteristic to distinguish rosacea from SS by using reflectance confocal microscopy (RCM).
Forty rosacea patients and 143 healthy subjects were recruited in this study. Firstly, a SS questionnaire and a lactic acid sting test were conducted among healthy subjects. Next, two major groups were divided out, including a SS group (40 subjects) and a normal skin control group (NS, 60 subjects). The cutaneous structures of face and fossa cubitalia were imaged by RCM.
We found that more parakeratosis, honeycomb pattern, spongiform edema, and dermal papillae (P < .05) in rosacea patients than that of the NS group, whereas there were no significant differences, were found in rosacea patients and the SS group. Strikingly, we found that rosacea patients have a larger depth of honeycomb pattern than that of SS subjects (P < .05). But, the epidermal thickness of rosacea did not differ from that of SS groups. There was also no significant difference of epidermal thickness and honeycomb structure depth between rosacea patients and NS group.
From the RCM images of parakeratosis, honeycomb pattern, spongiform edema, and dermal papillae, we found that RCM might be a faithful tool to distinguish rosacea from NS group. The depth of honeycomb structure of SS was more superficial than rosacea patients, whereas no significant difference between rosacea patients and NS group. RCM may provide a new method for evaluating the development of rosacea although it failed to distinguish rosacea and SS effectively.
最新的酒渣鼻标准分类和病理生理学为评估提供了明确且有意义的参数；然而，区分酒渣鼻和敏感性皮肤（SS）仍然是全世界皮肤科医生面临的一个障碍，尤其是在中国。在此，我们旨在通过使用反射共聚焦显微镜（RCM）找到更好的特征来区分酒渣鼻和 SS。
本研究纳入了 40 名酒渣鼻患者和 143 名健康受试者。首先，在健康受试者中进行了 SS 问卷和乳酸刺痛试验。接下来，将两个主要组分为 SS 组（40 名受试者）和正常皮肤对照组（NS，60 名受试者）。通过 RCM 对面部和肘窝皮肤结构进行成像。
我们发现，与 NS 组相比，酒渣鼻患者的角化过度、蜂窝状模式、海绵状水肿和真皮乳头更多（P<.05），而酒渣鼻患者与 SS 组之间则无明显差异。值得注意的是，我们发现酒渣鼻患者的蜂窝状模式深度大于 SS 组（P<.05）。然而，酒渣鼻患者的表皮厚度与 SS 组无差异。酒渣鼻患者与 NS 组的表皮厚度和蜂窝结构深度也无显著差异。
从角化过度、蜂窝状模式、海绵状水肿和真皮乳头的 RCM 图像中，我们发现 RCM 可能是区分酒渣鼻和 NS 组的可靠工具。SS 的蜂窝结构深度比酒渣鼻患者更浅，而酒渣鼻患者与 NS 组之间无显著差异。虽然 RCM 未能有效区分酒渣鼻和 SS，但它可能为评估酒渣鼻的发展提供了一种新方法。
