疣状表皮发育不良的共聚焦激光扫描显微镜下表现

The Features of Epidermodysplasia Verruciformis under Confocal Laser Scanning Microscopy

目的对疣状表皮发育不良患者皮损的共聚焦激光扫描显微镜(CLSM)图像特征进行初步探索。方法对在我院就诊高度怀疑为疣状表皮发育不良的患者,选定皮损处先做共聚焦激光扫描显微镜扫描,再在该处行组织病理检查,并在皮损附近正常皮肤处做CLSM检查,用做皮损对照。同时选取临床诊断为扁平疣的20例患者与之对照。结果皮损处CLSM图像可见明亮的角质层增厚,表皮中上部较多体积大,形状不规则,大小不一,胞质低折光率呈现黑色的空泡细胞,真皮浅层血管周围可见少量高折光度的淋巴细胞。对照组扁平疣患者CLSM扫描图像:其空泡细胞大小较为一致,呈圆形、椭圆形或梭形,胞质折光率较低。结论疣状表皮发育不良的CLSM图像有一定的特征性,但由于例数有限,其特征有待于进一步发现和证实,此外它能监测该病的动态变化。但应注意与易混淆的CLSM图像相鉴别。

Objective To conduct a preliminary exploration for the features of Epidermodysplasia Verruciformis under confocal laser scanning microscopy. Methods To the patients who were reasonable doubt of epidermaldysplasia verruciformis, we examined the selected skin lesions and the normal skin nearby also for contrast by confocal laser scanning microscopy, and then make histopathologic examination on the lesions. Finally we make comparison between them. Besides, we select 20 patients who are diagnosed as verruca plana for contrast. Results Characteristic of the lesions under the CLSM showed that bright stratum corneum incrassate; there were lots of irregular shape and not of uniform size physaliphores in the superficial dermis, the cytoplasm was of low refraction and black. Around the vascular there were a few inflammatory cells which were of high diopter. The CLSM images of the control group of verruca plana showed that the sizes of physaliphores were of uniform sizes. They were round, oval or spindle. The cytoplasmic refractive index was low. Conclu- sion The images of CLSM have characteristics , but due to the limited number, its features need to be further proved and discovered. Besides we can monitor the dynamic changes of the disease with it. We should distinguish it from the other easily confused CLSM images.