斑秃共聚焦激光扫描显微镜影像学特征分析  

In vivo imaging of alopecia areata with confocal laser scanning microscopy

作　　者：后桂荣[1] 肖艳[1] 曾抗[1] 

机构地区：[1]南方医科大学南方医院皮肤科,广州510515

出　　处：《中华皮肤科杂志》2012年第4期246-248,共3页Chinese Journal of Dermatology

摘　　要：目的通过在体共聚焦激光扫描显微镜（CLSM）采集斑秃的微解剖图像，研究斑秃的CLSM影像学特征。方法2010年1月至2011年5月，临床诊断斑秃患者46例。选定患处皮损及31例皮损附近正常皮肤行CLSM检查，并与斑秃的组织病理象作比较。结果CLSM显示，单位面积内毛囊数目斑秃进展期[（134．856±18．301）／cm2]及静止期[（147．159±17．536）／cm2]均显著低于正常对照组[（301．613±35．317）／cm2，P值均〈0．05]，毛囊内毛干缺失，毛囊周围、毛囊及真皮浅层毛细血管周围可见炎细胞浸润，静止期炎细胞浸润程度较进展期减轻；恢复期[（227．778±16．861）／cm2]毛囊数目较进展期增加，但仍少于正常对照（P〈0．05），可见毳毛及终毛生长，炎细胞浸润进一步减少。结论斑秃CLSM图像与常规组织病理表现相符合，CI-SM描述斑秃细胞水平的成像特点，可用于斑秃的临床观察及动态随访。Objective To assess the microscopic features of alopecia areata （AA） by using in vivo confocal laser scanning microscopy （CLSM）. Methods Between January 2010 and May 2011, 26 male and 20 female patients diagnosed with AA were enrolled in this study. AA lesions and perilesional normal skin were examined by means of in vivo CLSM. Tissue specimens were obtained from the lesions and perilesional normal skin of 10 out of the 46 patients and subjected to routine histopathologic examination. Results The number of hair follicles per unit area （cm2） was decreased in lesions of progressive AA and resting AA compared with normal perilesional skin （134.856 ± 18.301 and 147.159 ± 17.536 vs. 301.613 ± 35.317, both P 〈 0.05）. Although the quantity of hair follicles increased in lesions of recovery AA （（227.778 ＋ 16.861 ）/cm2）, but was still less than that in the normal perilesional skin （P 〈 0.05 ）. There was a lack of hair shaft in follicles, as well as an inflammatory infiltration in hair follicles, around hair follicles and capillaries in superficial dermis in lesions of progressive AA. The inflammatory infiltration was attenuated in lesions of resting AA. In lesions of recovery AA, the infiltration was further attenuated with an apparent growth of lanugos and terminal hairs. Conclusions As far as AA lesions are concerned, CLSM images are consistent with histopathological findings. CLSM may serve as a promising tool for monitoring efficacy and predicting prognosis based on hair growth cycle, hair follicle number, and inflammatory infiltration degree.

关 键 词：显微镜检查 共焦 斑秃 

分 类 号：R758.71[医药卫生—皮肤病学与性病学]