Department of Dermatology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
Microsc Res Tech. 2024 Dec;87(12):2842-2849. doi: 10.1002/jemt.24645. Epub 2024 Jul 19.
Bowen's disease (BD) is a relatively rare early-stage squamous cell carcinoma in situ, most commonly affecting the middle-aged and elderly, and occurring on the skin or mucous membranes of various parts of the body. Its onset is concealed, the course of the disease is chronic, and some patients have malignant tumors outside the skin; therefore, it is necessary to diagnose and evaluate the disease at an early stage. This study aimed to investigate the application of reflectance confocal microscopy (RCM) in the diagnosis of BD. We performed RCM imaging on the lesion site and underwent skin biopsy for histological diagnosis of 92 patients initially diagnosed with BD in clinic. A retrospective analysis of the RCM result as well as the histological examination revealed that after analyzing RCM images, out of 92 biopsy lesions, 61 were diagnosed with BD, of which 54 were consistent with RCM diagnosis. Among the 59 cases diagnosed with BD by RCM, 54 cases were consistent with the histological diagnosis. Afterwards, we analyzed the RCM characteristics in patients with BD verified by biopsy, and compared the RCM images of two different lesions, classic Bowen's disease and pigmented Bowen's disease, and further summarized the key points of BD under RCM. Finally, we focused on the differential characteristics between BD and other skin diseases in RCM. RCM is of great value in the diagnosis of BD. RESEARCH HIGHLIGHTS: A retrospective study of RCM and histological diagnosis in patients with clinical diagnosis of BD. Analyze the RCM characteristics of skin lesions verified by biopsy. RCM is of great value in the diagnosis and differentiation of BD.
鲍文病（BD）是一种较为罕见的早期原位鳞状细胞癌，多发生于中老年人，可发生于身体各部位的皮肤或黏膜。其发病隐匿，病程慢性，部分患者皮肤外有恶性肿瘤，因此需要早期诊断和评估病情。本研究旨在探讨反射共聚焦显微镜（RCM）在 BD 诊断中的应用。我们对 92 例临床初诊为 BD 的患者病变部位进行 RCM 成像，并进行皮肤活检行组织学诊断。对 RCM 结果及组织学检查进行回顾性分析，结果显示，在 92 例活检病变中，经分析 RCM 图像，有 61 例诊断为 BD，其中 54 例与 RCM 诊断一致。在 59 例经 RCM 诊断为 BD 的病例中，有 54 例与组织学诊断一致。随后，我们分析了经活检证实的 BD 患者的 RCM 特征，并比较了经典鲍文病和色素性鲍文病两种不同病变的 RCM 图像，进一步总结了 RCM 下 BD 的要点。最后，我们重点关注了 RCM 中 BD 与其他皮肤疾病的鉴别特征。RCM 对 BD 的诊断具有重要价值。研究亮点：对临床诊断为 BD 的患者进行 RCM 和组织学诊断的回顾性研究。分析经活检证实的皮肤病变的 RCM 特征。RCM 在 BD 的诊断和鉴别诊断中有重要价值。
