中华皮肤科杂志 ›› 2012, Vol. 45 ›› Issue (11): 789-791.

• 论著 • 上一篇    下一篇

汗孔角化病临床病理及皮肤共聚焦激光显微镜特征分析

陈柳青1,陈红英1,黄萌1,夏云2,马玲1,陈龙3,孔庆云1,张慧芳1   

  1. 1. 武汉市第一医院皮肤科
    2. 武汉华中科技大学同济医学院附属同济医院皮肤科
    3. 武汉市一医院皮肤科
  • 收稿日期:2011-12-05 修回日期:2012-07-10 出版日期:2012-11-15 发布日期:2012-10-31
  • 通讯作者: 陈柳青 E-mail:chlq35@yahoo.com.cn

Analysis of clinicopathological and confocal laser scanning microscopic features of porokeratosis

  • Received:2011-12-05 Revised:2012-07-10 Online:2012-11-15 Published:2012-10-31
  • Contact: Liu-qing CHEN E-mail:chlq35@yahoo.com.cn

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摘要：

目的 分析汗孔角化病病理学特征及共聚焦激光显微镜的特征表现。方法 回顾分析经活检病理诊断的186例汗孔角化病患者的临床及病理学特征，并对其中16例浅表播散性汗孔角化病进行共聚焦显微镜观察。结果 大部分患者具有典型的汗孔角化病皮损，即有堤状隆起的线状边缘的丘疹或斑块。组织病理均可见角化不全柱，大部分（171/186）汗孔角化柱与汗腺或毛囊无关，15例见于汗孔和毛囊内，角化不全柱下方可见角化不良细胞和局灶性基底细胞空泡化变性，真皮浅层可见不等量的淋巴细胞和噬色素细胞，2例在真皮乳头可见淀粉样物质沉积。激光共聚焦显微镜检测汗孔角化病，棘细胞层中可见特征性弧形排列的角化不全细胞。结论 汗孔角化病皮肤共聚焦激光显微镜图像可与常规组织病理表现相符合，是一种比较敏感和特异的无创性检测汗孔角化病的方法。

关键词: 共聚焦显微镜

Abstract:

Objective To assess the clinicopathological and confocal microscopic features of porokeratosis. Methods This study included 186 patients with porokeratosis. The clinical and pathological findings from the patients were retrospectively analyzed. Confocal laser scanning microscopy （CLSM） was used to observe the lesions of disseminated superficial porokeratosis in 16 patients. Results Most of the patients had characteristic lesions of porokeratosis, i.e., papules or plaques with a thread-like elevated border. Cornoid lamella was observed in all of the cases, which was unassociated with sweat glands or hair follicles in most cases （171/186）, and located in sweat pore or hair follicles in a few cases （15/186）. There were dyskeratocytes as well as vacuolized and degenerated basal cells beneath the cornoid lamella. Varying amounts of lymphocytes and melanophages were observed in the superficial dermis. Amyloid was deposited in the papilla dermis in 2 cases. CLSM showed dyskeratocytes in a characteristic arcuate arrangement in spinous cell layer. Conclusions The CLSM images of porokeratosis are consistent with its histopathological manifestations, and CLSM may serve as a sensitive and specific noninvasive method for the diagnosis of porokeratosis.

Key words: Confocal