反射式共聚焦显微镜在丘疹鳞屑性皮肤病诊断中的应用新进展

New Progress in Application of Reflectance Confocal Microscopy in the Skin Diseases Diagnosis of Papules and Scales

主要总结并探讨几种常见的丘疹鳞屑性皮肤病在反射式共聚焦显微镜(reflectance confocal microscopy,RCM)下的镜像特征以及RCM技术在丘疹鳞屑性皮肤病辅助诊断中的应用进展。其中寻常性银屑病的RCM研究较多且相对深入,已建立了观察银屑病不同病期及疗程的量化指标。玫瑰糠疹的RCM研究比较缺乏,可能与该病相对无特异性组织病理学表现和有限的RCM分辨率有关。扁平苔藓的RCM诊断可以达到类似于特异性组织病理学改变的水准,但毛发红糠疹应用RCM观察其特异性组织病理表现相对困难。硬化性萎缩性苔藓和光泽苔藓的RCM研究虽少但其表现较为特异。RCM技术已为皮肤病的诊断和鉴别诊断提供了极大帮助,有待设备技术的更新改良和更多简便实用的应用研究来进一步提高其应用效果及前景。

This paper mainly reviews and discusses the Reflectance Confocal Microscopy（RCM） features of several common papules scaly skin diseases and the application of RCM in the auxiliary diagnosis of these diseases. There are relatively deep and thorough stud- ies on psoriasis vulgaris,and quantitative indicators of difterent stages and courses of psoriasis have heen established. The lack of RCM studies of pityriasisrosea may he re- lated to the relative ahsence of specific histopathologieal findings and the limited RCM resolution. The RCM diagnosis of lichen planus can reach the similar levels of specific histopathological changes,but the use of RCM to observe the specific histopathological features of pityriasisruhrapilarisis is relatively difficult. Ahhough stt, dies on lichen sclerosusetatrophicus and lichen nitidus are less,their RCM features are more specif- it. RCM technology has provided great help for the diagnosis and differential diagnosis of skin diseases. Its application effect needs to be improved by updated technology and more simple and practical diagnosis researches.