原发性皮肤淀粉样变反射式共聚焦显微镜成像特征分析  

Reflectance confocal microscopic characteristics of primary cutaneous amyloidosis

作　　者：王蕾[1] 黄骏[1] 单筠筠[1] 许爱娥[1] Wang Lei;Huang Jun;Shan Yunyun;Xu Ai’e(Department of Dermatology,Hangzhou Third People′s Hospital,Hangzhou 310009,China)

机构地区：[1]杭州市第三人民医院皮肤科,310009

出　　处：《中华皮肤科杂志》2019年第4期265-267,共3页Chinese Journal of Dermatology

摘　　要：目的利用反射式共聚焦显微镜(RCM)观察原发性皮肤淀粉样变的成像特征。方法对2015年6月至2016年10月杭州市第三人民医院皮肤科门诊收集的30例临床确诊为原发性皮肤淀粉变患者的皮损进行RCM观察和组织病理检查,分析RCM特征。结果原发性皮肤淀粉变皮损RCM检查显示,角化过度22例,棘层肥厚15例,基底层色素增加20例,真皮乳头及浅层色素失禁20例,30例真皮乳头增大出现多形性,且可见高折光的团块状物质。这些RCM主要特征与组织病理有较高的一致性。结论原发性皮肤淀粉样变在RCM下的典型特征为真皮乳头内呈现折光度较高的团块状物质,RCM可作为原发性皮肤淀粉样变的无创性辅助诊断技术。Objective To investigate the reflectance confocal microscopic features of primary cutaneous amyloidosis.Methods A total of 30 outpatients with confirmed primary cutaneous amyloidosis were enrolled from Department of Dermatology,Hangzhou Third People's Hospital between June 2015 and October 2016.Their lesions were observed by reflectance confocal microscopy(RCM),and subjected to histopathological examination.Results RCM imaging of primary cutaneous amyloidosis lesions showed hyperkeratosis in 22 cases,acanthosis in 15,hyperpigmentation in the basal cell layer in 20,incontinence of pigment in the dermal papilla and superficial dermis in 20,and enlarged polymorphous dermal papilla with highly refractive clumps in 30.These RCM features were highly consistent with histopathological findings.Conclusion The typical RCM characteristic of primary cutaneous amyloidosis is highly refractive clumps in the dermal papilla,and RCM may serve as a non-invasive tool for assisting diagnosis of primary cutaneous amyloidosis.

关 键 词：淀粉样变性 显微镜检查 共焦 

分 类 号：R758.6[医药卫生—皮肤病学与性病学]