胶带粘贴法观察窄谱中波紫外线治疗后白癜风皮损的复色

Dynamic observation of repigmentation in vitiligo lesions after narrow-band ultraviolet B phototherapy by using an adhesive tape stripping technique

目的探讨窄谱中波紫外线（NB-UVB）治疗前后照射区浅表角质层细胞中黑素颗粒的变化。方法使用胶带粘贴法对接受NB-UVB治疗的白癜风皮损进行浅表角质层细胞取样，银氨染色后观察细胞中黑素颗粒形态、分布、颜色的变化，使用Image—ProPlus6．0显微图像分析软件计算细胞内黑素颗粒面积百分比，使用SPSS11．5对数据进行统计分析。结果治疗前白斑区仍残存少量含黑素颗粒的浅表角质层细胞。治疗前黑素颗粒面积百分比为（5．31±4．12）％，治疗10次后为（6．24±2．65）％，治疗20次后为（10．14±5．73）％，治疗30次后为（13．05±6．17）％，方差分析显示，治疗前、治疗10次、治疗20次、治疗30次后黑素颗粒面积百分比差异有统计学意义（F=4．334，P〈0．05），经两两比较分析，治疗30次后细胞内黑素颗粒面积百分比相对治疗前及治疗10次后均增高（P值均〈0．01）。皮损复色区新生黑素颗粒染色后形态、颜色与治疗前周边正常肤色区有所不同。结论用浅表角质层细胞胶带粘贴法可以客观评估NB—UVB治疗白癜风的复色过程。

Objective To observe the changes of melanin granules in superficial corneocytes in vitiligo lesions after irradiation with narrow-band ultraviolet B （NB-UVB） by using an adhesive tape stripping technique. Methods Vitiligo lesions were selected from 6 patients and irradiated with NB-UVB every other day for 31 sessions. Superficial corneocytes were obtained by an adhesive tape stripping technique from the vitiligo lesions and perilesional normal skin before every treatment. The morphology, distribution and color of melanin granules were observed after Masson-Fontana silver staining. The percentage of area occupied by melanin granules in superficial corneocytes were calculated by using the Image-Pro Plus 6.0 software. Statistical analysis was conducted by the SPSS11.5 software. Results There were still a few superficial corneocytes containing melanin granules remaining in the vitiligo lesions before treatment. The percentage of area occupied by melanin granules was （5.31 -＋ 4.12）% before treatment, （6.24 ：t： 2.65）% after 10 treatment sessions, （10.14 ＋ 5.73）% after 20 sessions, and （13.05 _＋ 6.17）% after 30 sessions, with significant differences between these time points （F = 4.334, P 〈 0.05）. Multiple comparisons revealed a significant increase in the percentage of area occupied by melanin granules after 30 treatment sessions compared with those before treatment and after 10 treatment sessions （both P 〈 0.01 ）. The morphology and color of melanin granules in repigmented lesions after treatment differed from those in perilesional normal skin before treatment. Conclusion The adhesive tape stripping technique may serve as a useful tool for the evaluation of repigmentation in vitiligo lesions after phototherapy.