麻风病皮损的反射式共聚焦显微镜图像特征

Image features of leprosy with reflectance confocal microscopy

目的:探讨麻风病皮损的反射式共聚焦显微镜(RCM)图像特征,为无创辅助诊断麻风病提供新方法。方法:采用RCM检查8例麻风病患者皮损,与同处皮损的组织病理对照,分析其图像特征及意义。结果:与组织病理特点比对,麻风病皮损RCM图像特点为:瘤型麻风(LL)、界线类偏瘤型(BL)见表皮萎缩、角化过度、棘层萎缩,真皮浅层片、灶状"蛙籽样"组织细胞(泡沫细胞)浸润,明显可见"无浸润带"形成;界线类偏结核样型(BT)见角化过度,真皮浅层血管扩张,管周散在淋巴细胞和组织细胞浸润。结论:RCM可以作为筛查麻风病的辅助检查技术,为今后麻风病的诊断与鉴别提供新的思路和方法。

Objective:To explore the image features of reflectance confocal microscopy(RCM) in leprosy lesions, and to provide a new method for non-invasive auxiliary diagnosis of leprosy. Methods:Reflectance confocal microscopy(RCM) was used to examine the skin lesions of 8 patients with leprosy. Results:The RCM images showed epidermal atrophy, hyperkeratosis, atrophy of the spinous layer, diffuse and patched infiltration of ″frogspawn like″ histiocytes(foam cells) in the superficial dermis in LL and BL lesions, clearly showed the formation of ″Grenz zone″;In BT, that was hyperkeratinized, with vascular vessel dilatation in the superficial dermis, and sporadic perivascular infiltration of lymphocytes and histiocytes. Conclusion:RCM can be used as an auxiliary screening technology for leprosy, and provide a new method for the diagnosis and differentiation of leprosy in the future.