反射式共聚焦显微镜联合皮肤镜在黄褐斑皮损黑素与血管评估中的应用

中华皮肤科杂志 ›› 2016, Vol. 49 ›› Issue (8): 591-594.

反射式共聚焦显微镜联合皮肤镜在黄褐斑皮损黑素与血管评估中的应用

黄骏¹,许爱娥²

1. 浙江中医药大学附属杭州第三医院
2. 安徽医科大学附属杭州市第三人民医院皮肤科

收稿日期:2015-09-15 修回日期:2016-04-13 发布日期:2016-08-05
通讯作者: 许爱娥 E-mail:xuaiehz@msn.com
基金资助:
国家自然科学基金;国家自然科学基金;卫生部科学研究基金——浙江省医药卫生重大科技计划;杭州市重大科技创新项目

Application of reflectance confocal microscopy combined with dermoscopy in assessing melanin and blood vessels in chloasma lesions

¹,

Received:2015-09-15 Revised:2016-04-13 Published:2016-08-05

摘要/Abstract

摘要：

目的用反射式共聚焦显微镜（RCM）及皮肤镜观察黄褐斑皮损中黑素及血管数量和形态，探讨黑素和血管与皮损颜色的关系。方法用RCM观察135例黄褐斑患者皮损中黑素数量及分布，其中54例患者RCM观察皮损中黑素形态和树突状黑素细胞，皮肤镜观察皮损中血管数量和形态。Spearman相关分析法分析黑素和血管与临床皮损颜色的关系。结果 135例患者表皮层和真表皮交界处黑素均增加，36例（27%）真皮浅层黑素增加，未发现单纯真皮黑素增加而无表皮增加的情况。54例患者中，黑素数量评分与形态评分呈正相关（r = 0.73，P＜0.001），血管数量评分与形态评分呈正相关（r = 0.87，P＜0.001）；黑素与血管评分总分呈正相关（r = 0.554，P＜0.001）。黑素数量、黑素形态、血管数量、血管形态均与皮损颜色呈正相关（r值分别为0.51、0.39、0.46、0.44，均P＜0.05）。结论反射式共聚焦显微镜和皮肤镜可用于黄褐斑皮损中黑素和血管情况评估，黄褐斑皮损中黑素数量及形态与血管数量及形态均呈正相关，黑素及血管数量和形态与临床皮损颜色亦均呈正相关。

Abstract:

Huang Jun, Xu Ai′e Department of Dermatology, Third People′s Hospital of Hangzhou, Zhejiang University of Traditional Chinese Medicine, Hangzhou 310009, China Corresponding author: Xu Ai′e, Email: xuaiehz@msn.com 【Abstract】 Objective To investigate the morphology and quantity of melanin and blood vessels in chloasma lesions by using reflectance confocal microscopy （RCM） and dermoscopy, and to explore the relationship of melanin and blood vessels with lesion color. Methods RCM was used to evaluate the quantity and distribution of melanin in lesions of 135 patients with chloasma, and to observe the morphology of melanin and dendritic melanocytes in 54 of the 135 patients, and dermoscopy was performed to assess the quantity and morphology of blood vessels in lesions of the 54 patients. Statistical analysis was carried out by Spearman correlation analysis to assess the relationship of melanin and blood vessels with lesion color. Results Increased quantity of melanin was observed in both the epidermal layer and dermo?epidermal junction in all the 135 patients, and in only the superficial dermis in 36 （27%） patients. No patients showed increased quantity of melanin in only the dermis without epidermal involvement. Among the 54 patients, there was a positive correlation between the quantity score and morphology score of melanin （r = 0.73, P < 0.001）, between the quantity score and morphology score of blood vessels （r = 0.87, P < 0.001）, as well as between the total melanin score and total blood vessel score （r = 0.554, P < 0.001）. Lesion color was positively correlated with the quantity and morphology of melanin （r = 0.51, 0.39, respectively, both P < 0.05） and blood vessels （r = 0.46, 0.44, respectively, both P < 0.05）. Conclusions RCM and dermoscopy can be used to evaluate melanin and blood vessels in chloasma lesions. There is a positive correlation between the quantity and morphology of melanin and between those of blood vessels in chloasma lesions, and lesion color is positively correlated with the quantity and morphology of melanin and blood vessels.

黄骏许爱娥. 反射式共聚焦显微镜联合皮肤镜在黄褐斑皮损黑素与血管评估中的应用[J]. 中华皮肤科杂志, 2016,49(8):591-594. doi:

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