中华皮肤科杂志 ›› 2016, Vol. 49 ›› Issue (10): 731-733.

• 研究报道 • 上一篇    下一篇

共聚焦激光扫描显微镜鉴别脂溢性角化病与鲍恩病

邹云敏1,于世荣2,吴秀娟2,张德志1,刘建勇2,3,吴曹英4,康晓静5   

  1. 1. 新疆维吾尔自治区人民医院
    2. 新疆维吾尔自治区人民医院皮肤性病科
    3.
    4. 新疆乌鲁木齐天山区天池路91号自治区人民医院皮肤性病科
    5. 乌鲁木齐市 新疆维吾尔自治区人民医院皮肤科
  • 收稿日期:2016-01-06 修回日期:2016-03-07 出版日期:2016-10-15 发布日期:2016-09-30
  • 通讯作者: 康晓静 E-mail:drkangxj666@163.com
  • 基金资助:

    自治区卫生厅青年科技人才科研项目

Application of confocal laser scanning microscopy in the differentiation between seborrheic keratosis and Bowen′s disease

  • Received:2016-01-06 Revised:2016-03-07 Online:2016-10-15 Published:2016-09-30

摘要:

目的 探讨共聚焦激光扫描显微镜(CLSM)在脂溢性角化病与鲍恩病鉴别中的应用价值。方法 选88例临床诊断为脂溢性角化病和18例临床诊断为鲍恩病的患者典型皮损做CLSM检查,然后取该处皮损行组织病理学检查。结果 脂溢性角化病CLSM图像特征:全部有表皮脑回状结构,另有角蛋白充填的囊性包裹体,表皮突呈小梁状下延;基底层细胞排列呈条索状或放射状9例,基底层及真皮层可见折光性明亮的结构6例。鲍恩病CLSM图像特征:表皮中下层细胞灶状排列紊乱,体积较大,细胞形态不规则,有明显的异形,真皮浅层散在单个核细胞浸润。结论 脂溢性角化病与鲍恩病在CLSM成像上有不同的特征性,CLSM可为二者的鉴别诊断提供帮助。

Abstract:

Zou Yunmin, Yu Shirong, Wu Xiujuan, Zhang Dezhi, Liu Jianyong, Wu Caoying, Kang Xiaojing Department of Dermatology, People′s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China Corresponding author: Kang Xiaojing, Email: drkangxj666@163.com 【Abstract】 Objective To evaluate the application value of confocal laser scanning microscopy (CLSM) in the differentiation between seborrheic keratosis and Bowen′s disease. Methods CLSM was used to observe typical skin lesions in 88 patients clinically diagnosed with seborrheic keratosis and 18 patients clinically diagnosed with Bowen′s disease. Then, tissue specimens were resected from these lesions and subjected to histopathological examination. Results CLSM imaging of seborrheic keratosis lesions showed gyrus-like structures and keratin-filled inclusion cysts in the epidermis with trabecula-like extension of rete ridges in all the 88 cases, basal cells arranged in a cordike or radial pattern in 9 cases, and bright reflective structures in the basal layer and dermis in 6 cases. CLSM imaging of Bowen′s disease lesions revealed disorderly arrangement of large, irregularly shaped atypical cells in some areas in the middle and lower epidermis, and infiltration of scattered mononuclear cells in the superficial dermis. Conclusion CLSM images of seborrheic keratosis are different from those of Bowen′s disease, and CLSM may be helpful for their differential diagnosis.