体内反射共聚焦显微镜在光化性角化病中的诊断价值。
The diagnostic value of in vivo reflectance confocal microscopy in actinic keratosis.
机构信息
Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China.
XiangYa School of Medicine, Central South University, Changsha, China.
出版信息
Skin Res Technol. 2021 Jan;27(1):80-85. doi: 10.1111/srt.12913. Epub 2020 Jul 22.
BACKGROUND
Actinic keratosis (AK) is a pre-neoplastic skin damage caused by sun exposure with a risk of transforming squamous cell carcinoma (SCC) ranging from 0.1%-20%, while it should be differentiated with many diseases such as seborrheic keratosis (SK), discoid lupus erythematosus (DLE), Bowen's disease, and basal cell carcinoma(BCC) et al. Reflectance confocal microscopy (RCM) as a non-invasive method is showing an increasing diagnostic accuracy. Currently, there are a few studies that summarized the characteristics of AK with RCM.
AIM
The study aimed to find the diagnostic value of diagnosing actinic keratosis by reflectance confocal microscopy.
METHODS
A total of 92 patients with clinical suspicious diagnosis of actinic keratosis were enrolled in this study, and RCM device imaged their lesions. Fifty-three of these patients underwent skin biopsies to confirm the diagnosis. We retrospectively analyzed the results of RCM and histological diagnosis and then summarized the RCM characteristics of biopsy-confirmed lesions.
RESULTS
Based on RCM images, 76 of 92 (82.6%) patients were diagnosed with AK, 9 of 92 (9.8%) patients could not be diagnosed by the dermatologist according to RCM. Of all 53 biopsied lesions, 42 (79.2%) were AK, 1 was seborrheic keratosis, 3 were basal cell carcinoma, three were discoid lupus erythematosus, 1 was Bowen's disease, and three were squamous cell carcinoma.
CONCLUSION
The value of RCM in the diagnosis and differential diagnosis of AK is good and worthy of clinical application.
背景
光化性角化病（AK）是一种由阳光暴露引起的癌前皮肤损伤，其转化为鳞状细胞癌（SCC）的风险为 0.1%-20%，而其需要与许多疾病如脂溢性角化病（SK）、盘状红斑狼疮（DLE）、鲍文病和基底细胞癌（BCC）等进行区分。反射共聚焦显微镜（RCM）作为一种非侵入性方法，其诊断准确性正在不断提高。目前，有一些研究总结了 RCM 对 AK 的特征。
目的
本研究旨在探讨反射共聚焦显微镜对光化性角化病的诊断价值。
方法
本研究共纳入 92 例临床疑似光化性角化病的患者，使用 RCM 设备对其皮损进行成像。其中 53 例患者进行了皮肤活检以明确诊断。我们回顾性分析了 RCM 和组织学诊断的结果，然后总结了经活检证实的病变的 RCM 特征。
结果
根据 RCM 图像，92 例患者中 76 例（82.6%）被诊断为 AK，9 例（9.8%）根据 RCM 无法由皮肤科医生进行诊断。在所有 53 例活检皮损中，42 例（79.2%）为 AK，1 例为脂溢性角化病，3 例为基底细胞癌，3 例为盘状红斑狼疮，1 例为鲍文病，3 例为鳞状细胞癌。
结论
RCM 在 AK 的诊断和鉴别诊断中的价值良好，值得临床应用。
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