探讨反射式共聚焦显微镜联合皮肤镜在儿童银屑病检查中的应用价值  

Application Value of Reflective Confocal Microscope Combined with Dermoscopy in Examination of Children Psoriasis

作　　者：高西波 王莹[1] 陈立新[1] 宫泽琨[1] 廉佳[1] 李钦峰[1] Gao Xibo;Wang Ying;Chen Lixin;Gong Zekun;Lian Jia;Li Qinfeng(Tianjin Children's Hospital,Tianjin 300134,China)

机构地区：[1]天津市儿童医院,天津300134

出　　处：《中国中西医结合皮肤性病学杂志》2023年第6期507-510,共4页Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine

摘　　要：目的探讨反射式共聚焦显微镜(RCM)联合皮肤镜在儿童银屑病中的应用价值。方法收集天津市儿童医院龙岩院区2019年7月—2021年7月收治的746例红斑鳞屑患儿的临床资料,对其中2名以上医师不能确诊为银屑病的78例患儿行RCM、皮肤镜和组织病理学检查,同时对检查结果进行比较及统计学分析。结果临床不能确诊为银屑病的78例患儿中,经组织病理学诊断实际为银屑病的患儿为65例,仅行RCM的阳性检出率为80.0%(52/65),仅行皮肤镜检查的阳性检出率为69.2%(45/65),行RCM联合皮肤镜检查后,阳性检出率为95.4%(62/65)。以组织病理活检为“金标准”,RCM联合皮肤镜组合检测的敏感度为95.4%(62/65),特异度为81.3%(13/16)。结论RCM联合皮肤镜的无创检查组合对诊断儿童银屑病有较高的敏感度和特异度,同时此无创检查的组合有无创、实时、动态及可重复性的优点,更适合应用于儿童银屑病的诊断。Objective In order to explore the value of reflectance confocal microscopy(RCM)combined with dermoscopy in diagnosising children's psoriasis.Methods Clinical data including 746 erythematosquamous skin diseases in children were collected between July 2019 and July 2021 from Tianjin Children's Hospital,of which 78 cases were suspicious of psoriasis required further RCM,dermoscopy and biopsy examination,then the results were analyzed.Results Among 78 patients,65 cases were conformed as psoriasis by biopsy.Positive detection rate was respectively 80.0%(52/65)by RCM and 69.2%(45/65)by dermoscopy test.Combining RCM with dermascopic examination,the positive detection rate was 95.4%(62/65).Taking the pathological biopsy as gold standard,the sensitivity of RCM-dermoscopy test was 95.4%(62/65)and the specificity was 81.3%(13/16).Conclusion The non-invasive application of RCM combines a high sensitivity with the advantage of noninvasive,real-time,dynamic and repeatable,which is more suitable for the diagnosis on children's psoriasis.

关 键 词：反射式共聚焦显微镜 皮肤镜 组织病理学 儿童银屑病 无创检查 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]