Rao Dermatology, 95 First Avenue, Atlantic Highlands, NJ, 07716, USA.
Center for Dermatology, Department of Pathology and Laboratory Science, Rutgers Robert Wood Johnson Medical School, 1 Worlds Fair Drive, Somerset, NJ, 08873, USA.
Lasers Med Sci. 2021 Jul;36(5):1077-1084. doi: 10.1007/s10103-020-03154-4. Epub 2020 Oct 17.
The evaluation of pigmented lesions on tattooed skin poses a diagnostic challenge for dermatologists, as a nevus may be partially or completely obscured by tattoo pigment. Because of incidences of melanoma arising from tattooed skin, the current gold standard is to biopsy these lesions. Reflectance confocal microscopy (RCM) is a noninvasive imaging modality used in the diagnosis and management of skin diseases that may allow for diagnosis, while preserving the tattoo design. Retrospective chart review was conducted to identify pigmented lesions on or near tattooed skin that were evaluated with RCM. Confocal characteristics and diagnoses were recorded and analyzed. Nineteen lesions from 15 patients were retrospectively reviewed. Tattoo pigment did not hinder evaluation and diagnosis of pigmented lesions on RCM. About 94.7% of lesions were diagnosed as benign melanocytic nevi by an expert confocal reader. One lesion was confocally diagnosed as melanocytic nevus with atypia but was found to be an inflamed melanocytic nevus on histology. Tattoo pigment particles were differentiated from other hyper-refractile entities by an expert confocal reader based on size, morphology, and clinical correlation. RCM may provide a solution to the diagnostic challenge of pigmented lesions on or near tattooed skin.
对纹身皮肤中色素性病变的评估对皮肤科医生来说是一个诊断挑战，因为痣可能部分或完全被纹身颜料所掩盖。由于来自纹身皮肤的黑色素瘤的发生率，目前的金标准是对这些病变进行活检。反射共聚焦显微镜（RCM）是一种用于诊断和管理皮肤疾病的非侵入性成像方式，它可以在保留纹身设计的同时进行诊断。对使用 RCM 评估的纹身皮肤或附近的色素性病变进行了回顾性图表审查。记录和分析了共焦特征和诊断。回顾性分析了 15 名患者的 19 个病变。纹身颜料并未妨碍 RCM 对色素性病变的评估和诊断。大约 94.7%的病变被专家共聚焦阅读器诊断为良性黑色素细胞痣。一个病变被共聚焦诊断为具有异型性的黑色素细胞痣，但在组织学上发现是炎症性黑色素细胞痣。纹身颜料颗粒的大小、形态和临床相关性可由专家共聚焦阅读器与其他高折射实体区分开来。RCM 可能为纹身皮肤或附近的色素性病变的诊断挑战提供解决方案。
