Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.
Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Skin Res Technol. 2022 May;28(3):480-486. doi: 10.1111/srt.13158. Epub 2022 Mar 28.
Dermoscopy and reflectance confocal microscopy (RCM) as noninvasive tools are gaining increasing importance in the diagnosis of inflammatory skin disorders. The purpose of our study was to calculate and compare the diagnostic accuracy of dermoscopy and RCM in common inflammatory skin diseases.
We retrospectively collected clinical, dermoscopic, and RCM images of psoriasis and lichen planuscases from March 2018 to February 2021 in China-Japan Friendship Hospital. There were 10 experts evaluated dermoscopic and RCM images independently. Sensitivity, specificity, positive predict value, and negative predictive value for each and all investigators were calculated. The diagnostic accuracy was also measured by the area under the curve (AUC) for the Receiver Operator Characteristic (ROC) Curves.
We collected 82 psoriasis and 47 lichen planus cases. Dermoscopy was more sensitive than RCM in the diagnosis of psoriasis, and overall diagnostic accuracy of dermoscopy was also higher than RCM measured by AUC (0.879 vs. 0.835, p = 0.0001). For lichen planus, RCM had higher sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy than dermoscopy (AUC 0.916 vs. 0.813, p<0.0001).
Dermoscopy and RCM play a significant role in assisting the diagnosis of psoriasis and lichens planus. These two noninvasive diagnostic tools have their own advantages and disadvantages for the evaluation of different inflammatory skin diseases, and they can be combined in clinical practice to improve the accuracy of the diagnosis of inflammatory skin diseases.
皮肤镜检查和反射共聚焦显微镜（RCM）作为非侵入性工具，在炎症性皮肤病的诊断中越来越重要。我们的研究目的是计算和比较皮肤镜检查和 RCM 在常见炎症性皮肤病中的诊断准确性。
我们在中国医学科学院皮肤病医院回顾性收集了 2018 年 3 月至 2021 年 2 月的银屑病和扁平苔藓病例的临床、皮肤镜和 RCM 图像。有 10 位专家独立评估了皮肤镜和 RCM 图像。计算了每位和所有研究者的敏感性、特异性、阳性预测值和阴性预测值。还通过接受者操作特征（ROC）曲线的曲线下面积（AUC）来衡量诊断准确性。
我们收集了 82 例银屑病和 47 例扁平苔藓病例。皮肤镜检查在银屑病的诊断中比 RCM 更敏感，总体诊断准确性也高于 RCM（AUC 0.879 与 0.835，p = 0.0001）。对于扁平苔藓，RCM 的敏感性、特异性、阳性预测值、阴性预测值和总体诊断准确性均高于皮肤镜检查（AUC 0.916 与 0.813，p<0.0001）。
皮肤镜检查和 RCM 在辅助诊断银屑病和扁平苔藓方面发挥了重要作用。这两种非侵入性诊断工具在评估不同的炎症性皮肤病方面各有优缺点，可以在临床实践中结合使用，以提高炎症性皮肤病的诊断准确性。
