中华皮肤科杂志 ›› 2024, Vol. 57 ›› Issue (9): 775-784.doi: 10.35541/cjd.20240237
中国中西医结合学会皮肤性病专业委员会 中华医学会皮肤性病学分会 中国医师协会皮肤科医师分会
收稿日期:
2024-05-06
修回日期:
2024-07-23
发布日期:
2024-09-04
通讯作者:
陈柳青;邹先彪
E-mail:chlq35@126.com; xbzou@126.com
基金资助:
Combination of Traditional and Western Medicine Dermatology; Chinese Society of Dermatology; China Dermatologist Association
Received:
2024-05-06
Revised:
2024-07-23
Published:
2024-09-04
Contact:
Chen Liuqing; Zou Xianbiao
E-mail:chlq35@126.com; xbzou@126.com
Supported by:
摘要: 【摘要】 黑素细胞性皮肤肿瘤发病率高,早期诊疗对于预后影响重大。反射式共聚焦显微镜(RCM)在黑素细胞性皮肤肿瘤的诊疗中已有应用,但一直缺少适用于皮肤肿瘤领域的统一诊疗指南或专家共识。由中国中西医结合学会皮肤性病专业委员会、中华医学会皮肤性病学分会、中国医师协会皮肤科医师分会相关领域的多位专家,结合临床经验、国内外相关文献及研究结果共同制订本共识。本共识阐述了正常皮肤的RCM特征、常用术语、成像规范及常见黑素细胞性皮肤肿瘤RCM表现及应用场景,供皮肤科医师在诊疗工作中参考。
中国中西医结合学会皮肤性病专业委员会 中华医学会皮肤性病学分会 中国医师协会皮肤科医师分会. 反射式共聚焦显微镜在常见黑素细胞性皮肤肿瘤中的应用专家共识(2024版)[J]. 中华皮肤科杂志, 2024,57(9):775-784. doi:10.35541/cjd.20240237
Combination of Traditional and Western Medicine Dermatology, Chinese Society of Dermatology, China Dermatologist Association. Expert consensus on the application of reflectance confocal microscopy in common melanocytic skin tumors(2024)[J]. Chinese Journal of Dermatology, 2024, 57(9): 775-784.doi:10.35541/cjd.20240237
[1] | Glazer AM, Winkelmann RR, Farberg AS, et al. Analysis of trends in US melanoma incidence and mortality[J]. JAMA Dermatol, 2017,153(2):225⁃226. doi: 10.1001/jamadermatol. 2016.4512. |
[2] | OCEBM Levels of Evidence Working Group. The Oxford Levels of Evidence 2[EB/OL]. Oxford Centre for Evidence⁃Based Medicine. https://www.cebm.ox.ac.uk/resources/levels⁃of⁃evidence/ocebm⁃levels⁃of⁃evidence. |
[3] | Navarrete⁃Dechent C, Liopyris K, Monnier J, et al. Reflectance confocal microscopy terminology glossary for melanocytic skin lesions: a systematic review[J]. J Am Acad Dermatol, 2021,84(1):102⁃119. doi: 10.1016/j.jaad.2020.05.097. |
[4] | Navarrete⁃Dechent C, DeRosa AP, Longo C, et al. Reflectance confocal microscopy terminology glossary for nonmelanocytic skin lesions: a systematic review[J]. J Am Acad Dermatol, 2019,80(5):1414⁃1427.e3. doi: 10.1016/j.jaad.2018.12.007. |
[5] | Ho G, Gill M, Grant⁃Kels J, et al. International expert recommendations on image acquisition for in vivo reflectance confocal microscopy of cutaneous tumors[J]. J Am Acad Dermatol, 2024,90(3):537⁃544. doi: 10.1016/j.jaad.2023.09. 086. |
[6] | Borsari S, Pampena R, Benati E, et al. In vivo dermoscopic and confocal microscopy multistep algorithm to detect in situ melanomas[J]. Br J Dermatol, 2018,179(1):163⁃172. doi: 10. 1111/bjd.16364. |
[7] | 郑亚杰, 沈雪, 竞艳, 等. 反射式共聚焦显微镜联合皮肤镜对黑素细胞痣的诊断价值评估[J]. 中华皮肤科杂志, 2017,50(7):517⁃520. doi: 10.3760/cma.j.issn.0412⁃4030.2017.07.011. |
[8] | 吕金, 万学峰, 多兰·达力汗. 共聚焦激光扫描显微镜在诊断色素痣、脂溢性角化症及色素型基底细胞癌的临床应用[J]. 临床皮肤科杂志, 2017,46(3):161⁃164. doi: 10.16761/j.cnki. 1000⁃4963.2017.03.005. |
[9] | 李岩, 王砚宁, 胡亚莉, 等. 色素痣的共聚焦激光扫描显微镜影像特征[J]. 临床皮肤科杂志, 2020,49(12):732⁃734. doi: 10.16761/j.cnki.1000⁃4963.2020.12.007. |
[10] | Mandel VD, Persechino F, Berardi A, et al. Congenital Glioblastoma multiforme and eruptive disseminated Spitz nevi[J]. Ital J Pediatr, 2016,42(1):47. doi: 10.1186/s13052⁃016⁃0260⁃9. |
[11] | Guida S, Pellacani G, Cesinaro AM, et al. Spitz naevi and melanomas with similar dermoscopic patterns: can confocal microscopy differentiate?[J]. Br J Dermatol, 2016,174(3):610⁃616. doi: 10.1111/bjd.14286. |
[12] | Iriarte C, Rao B, Haroon A, et al. Acral pigmented Spitz nevus in a child with transepidermal migration of melanocytes: dermoscopic and reflectance confocal microscopic features[J]. Pediatr Dermatol, 2018,35(2):e99⁃e102. doi: 10.1111/pde.13385. |
[13] | Pogorzelska⁃Antkowiak A, Slowinska M, Farinazzo E, et al. Spitz nevus and melanoma: evaluation with dermoscopy and reflectance confocal microscopy[J]. Postepy Dermatol Alergol, 2023,40(3):427⁃431. doi: 10.5114/ada.2023.125968. |
[14] | Drozdowski R, Spaccarelli N, Peters MS, et al. Dysplastic nevus partⅠ: historical perspective, classification, and epidemiology[J]. J Am Acad Dermatol, 2023,88(1):1⁃10. doi: 10.1016/j.jaad.2022.04.068. |
[15] | Vaišnorienė I, Rotomskis R, Kulvietis V, et al. Nevomelanocytic atypia detection by in vivo reflectance confocal microscopy[J]. Medicina (Kaunas), 2014,50(4):209⁃215. doi: 10.1016/j.medici. 2014.09.008. |
[16] | Borsari S, Pampena R, Lallas A, et al. Clinical indications for use of reflectance confocal microscopy for skin cancer diagnosis[J]. JAMA Dermatol, 2016,152(10):1093⁃1098. doi: 10.1001/jamadermatol.2016.1188. |
[17] | Pellacani G, Scope A, Gonzalez S, et al. Reflectance confocal microscopy made easy: the 4 must⁃know key features for the diagnosis of melanoma and nonmelanoma skin cancers[J]. J Am Acad Dermatol, 2019,81(2):520⁃526. doi: 10.1016/j.jaad.2019. 03.085. |
[18] | Lourari S, Lamant L, Viraben R, et al. Photoletter to the editor: blue nevus with satellitosis mimicking melanoma. Contribution of dermoscopy and reflectance confocal microscopy[J]. J Dermatol Case Rep, 2012,6(2):54⁃56. doi: 10.3315/jdcr.2012. 1097. |
[19] | Cinotti E, Couzan C, Perrot JL, et al. Reflectance confocal microscopy for the diagnosis of vulvar naevi: six cases[J]. J Eur Acad Dermatol Venereol, 2016,30(1):30⁃35. doi: 10.1111/jdv. 12924. |
[20] | Fei WM, Li CX, Cui Y. Diagnostic value of dermoscopy combined with reflectance confocal microscopy for clinically equivocal blue nevus[J]. Chin Med J (Engl), 2020,133(17):2116⁃2118. doi: 10.1097/CM9.0000000000001007. |
[21] | Schwartz RJ, Vera K, Navarrete N, et al. In vivo reflectance confocal microscopy of halo nevus[J]. J Cutan Med Surg, 2013,17(1):33⁃38. doi: 10.2310/7750.2012.12019. |
[22] | Porto AC, Blumetti TP, de Paula Ramos Castro R, et al. Recurrent halo nevus: dermoscopy and confocal microscopy features[J]. JAAD Case Rep, 2017,3(3):256⁃258. doi: 10.1016/j.jdcr.2017.02.020. |
[23] | Reilly C, Cucalon J, Chuchvara N, et al. 15272 Life cycle of a halo nevus: a noninvasive in vivo study using reflectance confocal microscopy[J]. J Am Acad Dermatol, 2020,83(6):AB33. doi: 10.1016/j.jaad.2020.06.220. |
[24] | Longo C, Farnetani F, Ciardo S, et al. Is confocal microscopy a valuable tool in diagnosing nodular lesions? A study of 140 cases[J]. Br J Dermatol, 2013,169(1):58⁃67. doi: 10.1111/bjd.12259. |
[25] | Waddell A, Star P, Guitera P. Advances in the use of reflectance confocal microscopy in melanoma[J]. Melanoma Manag, 2018,5(1):MMT04. doi: 10.2217/mmt⁃2018⁃0001. |
[26] | Mandel VD, Bombonato C, Pampena R, et al. Integration of dermoscopy and reflectance confocal microscopy for distinguishing melanomas from nevi of the breast area[J]. J Eur Acad Dermatol Venereol, 2018,32(6):940⁃946. doi: 10.1111/jdv.14685. |
[27] | Longo C, Mazzeo M, Raucci M, et al. Dark pigmented lesions: diagnostic accuracy of dermoscopy and reflectance confocal microscopy in a tertiary referral center for skin cancer diagnosis[J]. J Am Acad Dermatol, 2021,84(6):1568⁃1574. doi: 10.1016/j.jaad.2020.07.084. |
[28] | Pampín⁃Franco A, Gamo⁃Villegas R, Floristán⁃Muruzábal U, et al. Melanocytic lesions with peripheral globules: results of an observational prospective study in 154 high⁃risk melanoma patients under digital dermoscopy follow⁃up evaluated with reflectance confocal microscopy[J]. J Eur Acad Dermatol Venereol, 2021,35(5):1133⁃1142. doi: 10.1111/jdv.17105. |
[29] | Condorelli AG, Farnetani F, Ciardo S, et al. Dynamic dermoscopic and reflectance confocal microscopic changes of melanocytic lesions excised during follow up[J]. J Am Acad Dermatol, 2022,86(5):1049⁃1057. doi: 10.1016/j.jaad.2021.03. 081. |
[30] | Pellacani G, Farnetani F, Ciardo S, et al. Effect of reflectance confocal microscopy for suspect lesions on diagnostic accuracy in melanoma: a randomized clinical trial[J]. JAMA Dermatol, 2022,158(7):754⁃761. doi: 10.1001/jamadermatol.2022.1570. |
[31] | Correa⁃Selm L, Hanlon KL, Grichnik JM. Differentiating activated Langerhans cells and dendritic melanocytes using reflectance confocal microscopy: the limitations of diagnosing melanoma in vivo[J]. Lancet, 2023,401(10376):590. doi: 10. 1016/S0140⁃6736(23)00006⁃5. |
[32] | Gouveia BM, Carlos G, Wadell A, et al. In vivo reflectance confocal microscopy can detect the invasive component of lentigo maligna melanoma: prospective analysis and case⁃control study[J]. J Eur Acad Dermatol Venereol, 2023,37(7):1293⁃1301. doi: 10.1111/jdv.18998. |
[33] | Navarrete⁃Dechent C, Cordova M, Aleissa S, et al. Lentigo maligna melanoma mapping using reflectance confocal microscopy correlates with staged excision: a prospective study[J]. J Am Acad Dermatol, 2023,88(2):371⁃379. doi: 10.1016/j.jaad.2019.11.058. |
[34] | 吴冬梅, 李青, 戴耕武. 反射式共聚焦显微镜在皮肤恶性黑素瘤中的应用进展[J]. 实用皮肤病学杂志, 2015,(2):122⁃125. doi: 10.11786/sypfbxzz.1674⁃1293.20150214. |
[35] | Pellacani G, Cesinaro AM, Seidenari S. Reflectance⁃mode confocal microscopy of pigmented skin lesions⁃⁃improvement in melanoma diagnostic specificity[J]. J Am Acad Dermatol, 2005,53(6):979⁃985. doi: 10.1016/j.jaad.2005.08.022. |
[36] | Segura S, Puig S, Carrera C, et al. Development of a two⁃step method for the diagnosis of melanoma by reflectance confocal microscopy[J]. J Am Acad Dermatol, 2009,61(2):216⁃229. doi: 10.1016/j.jaad.2009.02.014. |
[37] | Cinotti E, Bertello M, Cartocci A, et al. Comparison of reflectance confocal microscopy and line⁃field optical coherence tomography for the identification of keratinocyte skin tumours[J]. Skin Res Technol, 2023,29(1):e13215. doi: 10.1111/srt. 13215. |
[38] | Sahu A, Yélamos O, Iftimia N, et al. Evaluation of a combined reflectance confocal microscopy⁃optical coherence tomography device for detection and depth assessment of basal cell carcinoma[J]. JAMA Dermatol, 2018,154(10):1175⁃1183. doi: 10.1001/jamadermatol.2018.2446. |
[39] | Floristán Muruzábal U, Gamo Villegas R, Pampín Franco A, et al. Combined in vivo reflectance confocal microscopy and digital dermoscopy for follow up of patients at high risk of malignant melanoma: a prospective case series study[J]. J Dermatol, 2017,44(6):681⁃689. doi: 10.1111/1346⁃8138.13743. |
[40] | Pellacani G, De Carvalho N, Ciardo S, et al. The smart approach: feasibility of lentigo maligna superficial margin assessment with hand⁃held reflectance confocal microscopy technology[J]. J Eur Acad Dermatol Venereol, 2018,32(10):1687⁃1694. doi: 10.1111/jdv.15033. |
[41] | Elshot YS, Tio D, van Haersma⁃de With A, et al. Lentigo maligna (melanoma): a systematic review and meta⁃analysis on surgical techniques and presurgical mapping by reflectance confocal microscopy[J]. J Eur Acad Dermatol Venereol, 2023,37(5):871⁃883. doi: 10.1111/jdv.18880. |
[42] | Navarrete⁃Dechent C, Cordova M, Liopyris K, et al. Reflectance confocal microscopy and dermoscopy aid in evaluating repigmentation within or adjacent to lentigo maligna melanoma surgical scars[J]. J Eur Acad Dermatol Venereol, 2020,34(1):74⁃81. doi: 10.1111/jdv.15819. |
[43] | Navarrete⁃Dechent C, Cordova M, Postow MA, et al. Evaluation of the response of unresectable primary cutaneous melanoma to immunotherapy visualized with reflectance confocal microscopy: a report of 2 cases[J]. JAMA Dermatol, 2019,155(3):347⁃352. doi: 10.1001/jamadermatol.2018.3688. |
[44] | Guitera P, Haydu LE, Menzies SW, et al. Surveillance for treatment failure of lentigo maligna with dermoscopy and in vivo confocal microscopy: new descriptors[J]. Br J Dermatol, 2014,170(6):1305⁃1312. doi: 10.1111/bjd.12839. |
[45] | Pampín Franco A, Gamo Villegas R, Floristán Muruzábal U, et al. Changes in melanocytic nevi after laser treatment evaluated by dermoscopy and reflectance confocal microscopy[J]. Int J Dermatol, 2016,55(5):e307⁃e309. doi: 10.1111/ijd.13083. |
[46] | Mandal A, Priyam S, Chan HH, et al. Computer⁃aided diagnosis of melanoma subtypes using reflectance confocal images[J]. Cancers (Basel), 2023,15(5):1428. doi: 10.3390/cancers1505 1428. |
[47] | Li J, Garfinkel J, Zhang X, et al. Biopsy⁃free in vivo virtual histology of skin using deep learning[J]. Light Sci Appl, 2021,10(1):233. doi: 10.1038/s41377⁃021⁃00674⁃8. |
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