雀斑样痣共聚焦激光扫描显微镜图像特征分析

In vivo imaging of lentigo with confocal laser scanning microscopy

目的通过在体共聚焦激光扫描显微镜（CLSM）采集雀斑样痣的图像，研究其影像学特征。方法30例临床诊断为日光性雀斑样痣、10例单纯性雀斑样痣患者，用CLSM观察皮损及皮损周边正常皮肤，并与组织病理学表现相比较。结果CLSM下所有雀斑样痣的主要表现在真表皮交界处，表现为表皮突延长，数目增多且基底层色素显著增加，形成几种不同的图像特征如形状不规则的真皮乳头环扩大，周围环绕折光度较高的细胞等。真皮浅层可见少许噬黑素细胞及淋巴细胞浸润。讨论雀斑样痣的CLSM图像与常规组织病理表现相符合。

Objective To assess the mieroscopie features of lentigo by using in vivo confoeal laser scanning microscopy （CLSM）. Methods This study included 30 patients clinically diagnosed with solar lentigo and 10 patients with lentigo simplex. Lentigo lesions and perilesional normal skin were examined by in vivo CLSM. Tissue specimens were also obtained from lesional and perilesional normal skin and subjected to routine histopathologie examination. Results The CLSM features of lentigo were mainly observed at the dermo-epidermal junction. In all of these cases of lentigo, there was an increase in the length and number of fete ridges, with a marked hyperpigmentation of the basal layer. Several distinct microscopic patterns were observed, such as extended, irregularly shaped papillary dermis surrounded by highly refractile cells （presumed to be basal keratinocytes）. Histopathologically, there was an infiltrate of a small quantity of melanophages and lymphocytes in superficial dermis. Conclusion As far as lentigo lesions are concerned, CLSM images are consistent with histopathological findings.