Abstract:

Su Haihui, Yuan Shiping, Duan Zhihua, Wang Xiaoyan Department of Dermatology, Tianjin Children′s Hospital, Tianjin 300074, China Corresponding author: Su Haihui, Email: suhaihui2004@sina.com 【Abstract】 Objective To assess the reflectance confocal microscopic features of childhood lichen planus （LP）, and to evaluate the performance of reflectance confocal microscopy （RCM） in the diagnosis of childhood LP. Methods RCM was performed for imaging of lesions in 35 children with LP. Then, biopsies were carried out at the same sites followed by histopathological examination. A comparison was conducted between confocal microscopic and histopathological findings. All the 35 cases were diagnosed based on clinical manifestations and histopathological findings. Results RCM imaging of lesions in the 35 cases showed cellular edema forming lowly reflective areas in the epidermis, sharp transition between the granular and spinous layers, and infiltration of moderately reflective inflammatory cells, which corresponded to wedge-shaped thickening of the granular layer on pathological examination. The dermo-epidermal junction was unclear, and dermal papillary rings were obscure or absent with infiltration of inflammatory cells arranged in lamelliform structures around the dermo-epidermal junction, which corresponded to interface dermatitis on histopathological examination. A band-like infiltration of inflammatory cells, including big, highly reflective oval or stelliform pigmentophages and small, moderately reflective round lymphocytes, was observed in the dermis, and the thickness of infiltration was measurable. Dilated blood vessels were longitudinally distributed in the papillary dermis with perivascular infiltration of inflammatory cells and pigmentophages. RCM images were highly consistent with histopathological findings in these patients. Conclusion RCM, as a real-time non-invasive imaging technique, can serve as an auxiliary examination method for the diagnosis of childhood LP.