雄激素性秃发的反射式共聚焦显微镜征象及意义  

Characteristics of androgenetic alopecia in reflectance confocal microscopy and their clinical significance

作　　者：车旭 赵建斌 CHE Xu;ZHAO Jianbin(Department of Dermatology,the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University,Xuzhou 221100,China)

机构地区：[1]徐州医科大学附属徐州市立医院皮肤性病科,徐州221100

出　　处：《实用皮肤病学杂志》2024年第1期8-11,共4页Journal of Practical Dermatology

摘　　要：目的观察雄激素性秃发(AGA)患者皮损区反射式共聚焦显微镜(RCM)特征性变化,并测量毛囊口大小,寻找该病特异性影像学征象。方法收集30例早期AGA患者(AGA组),26例健康对照者(对照组)的RCM征象及相关临床资料,并进行比较分析。结果使用毛囊口的周长和直径作为其大小的衡量指标,对照组毛囊口周长(521.01±144.55)μm,直径(165.84±46.01)μm,AGA组毛囊口周长(410.09±167.68)μm,直径(130.54±53.37)μm,2组比较差异具有统计学意义(P=0.000)。AGA组患者的毛囊RCM下征象按照出现频率由高到低依次为:规则的外轮廓(92.2%)、模糊的内轮廓(59.4%)、非反射性边界(76.6%)、毛囊角栓(38.9%)、洋葱圈样边界(7.8%);RCM下毛囊及周围组织征象按照出现频率由高到低依次为明亮的真皮乳头边界(76.7%)、毛囊周围和真皮浅层炎性细胞浸润(73.3%)、真皮以及附属器周围纤维组织硬化(46.7%)、真皮乳头血管扩张(33.3%)。结论RCM在早期诊断AGA具有重要的临床意义。Objective To investigate the characteristic changes of skin lesions among patients with androgenetic alopecia(AGA)in reflectance confocal microscopy(RCM),measure the size of the hair follicular orifice and identify specific imaging indicators associated with androgenetic alopecia.Methods The RCM features and corresponding clinical data were collected from 30 early-stage AGA patients 26 healthy individuals,followed by a comparative analysis.Results The perimeter and diameter of follicular orifice serve as quantitative indicators of its size.In the control group,the perimeter of the follicular orifice was(521.01±144.55)μm,with a diameter of(165.84±46.01)μm;whereas in the AGA group,the perimeter of the follicular orifice was was(410.09±167.68)μm with a diameter of(130.54±53.37)μm,and these differences between two groups were found to be statistically significant.The most common RCM features of the follicular orifice in AGA patients was regular outer contours(92.2%),followed by fuzzy inner contours(59.4%),non-reflective borders(76.6%),follicular plugs(38.9%),and onion ring-like borders(7.8%).The features of perifollicles and surrounding tissues under RCM were ranked by frequency as follows:rimmed dermal papillae(76.7%),inflammatory cell infiltration(73.3%),perifollicular and dermal fiber bundles thickening(46.7%),and dilated blood vessels(33.3%).Conclusion RCM plays a crucial role in the early diagnosis of androgenetic alopecia.

关 键 词：秃发 雄激素性 反射式共聚焦显微镜 毛囊微型化 

分 类 号：R758.71[医药卫生—皮肤病学与性病学]