皮肤镜联合RCM在头皮银屑病诊断中的应用

Application of Dermoscopy Combined with Reflectance Confocal Microscopy in the Diagnosis of Scalp Psoriasis

目的 探讨皮肤镜联合共反射式共聚焦激光扫描显微镜(RCM)在头皮银屑病诊断中的价值。方法 选取临床初步诊断为头皮银屑病的患者46例进行皮肤镜及RCM检查,并且行组织病理学检查。分别评估皮肤镜、RCM、皮肤镜联合RCM与组织病理之间的的一致性,比较各方法的诊断价值。结果 以病理诊断为金标准,皮肤镜准确率87.0%,灵敏度92.3%,特异度57.1%;RCM准确率82.6%,灵敏度82.1%,特异度85.7%;RCM联合皮肤镜准确率95.7%,灵敏度97.4%,特异度85.7%。皮肤镜、RCM、皮肤镜联合RCM与组织病理学检查结果之间的一致性评价,Kappa值分别为0.495、0.501和0.832。结论 皮肤镜联合RCM在头皮银屑病的诊断价值优于单一影像技术。

Objective In order to investigate the value of dermoscopy combined with reflectance confocal microscopy(RCM)in the diagnosis of scalp psoriasis. Methods A total of 46 patients with primary clinical diagnosis of scalp psoriasis were selected for undergoing with dermoscopy,RCM and histopathological examination. The consistency between dermoscopy,RCM,dermoscopy combined with RCM and histopathology was evaluated,and the diagnostic value of each method was compared. Results Pathological diagnosis was the gold standard. The accuracy,sensitivity and specificity of the dermoscopic diagnosis were 87%,92.3% and 57.1%;RCM were 82.6%,82.1% and 85.7%;and dermoscopy combined with RCM were95.7%,97.4% and 85.7%. The Kappa values were 0.495,0.501 and 0.832 respectively for the consistency evaluation of the results of dermoscope,RCM,dermoscope combined with RCM,suggesting that dermoscope combined with RCM was significantly superior to each single diagnostic technique. Conclusion The diagnostic value of dermoscopy combined with RCM is superior to single imaging technique.