Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China.
XiangYa School of Medicine, Central South University, Changsha, China.
Skin Res Technol. 2021 Jan;27(1):80-85. doi: 10.1111/srt.12913. Epub 2020 Jul 22.
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.
The study aimed to find the diagnostic value of diagnosing actinic keratosis by reflectance confocal microscopy.
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.
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.
The value of RCM in the diagnosis and differential diagnosis of AK is good and worthy of clinical application.
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。
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。
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。
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。
RCM 在 AK 的诊断和鉴别诊断中的价值良好，值得临床应用。
