摘要
Abstract
Objective To understand the reflectance confocal microscopy(RCM)characteris-tics of pediatric pityriasis lichenoides chronica and its value in clinical practice.Methods This study retrospectively analyzed the RCM features of 41 pediatric patients with pityriasis lichenoides chronica at the Pediatric Dermatology Department of Tianjin Academy of TCM Affiliated Hospital and compared them with histopathological findings.Results Under RCM,the skin lesions showed mild hyperkeratosis(60.97％),parakeratosis(90.24％),and irregular highly refractive substance within the epidermis(14.63％,particularly in hypopigmented areas).Mild focal spon-giotic edema in the stratum spinosum was observed(97.56％),with some cases showing intra-ep-idermal vesicle formation(21.95％).The dermo-epidermal junction was indistinct(73.17％),and focal liquefactive degeneration of the basal layer was present(90.24％).In the superficial dermis,various degrees of perivascular infiltration of melanophages(90.24％)and inflammatory cells(100％)were observed.Extravasated erythrocytes around superficial blood vessels were also seen in purpuric lesions(24.39％).The frequency of focal liquefaction degeneration of the basal cell layer varied significantly with different skin lesions(P＜0.05),with hypopigmentation＞ery-thematous papules with scaling＞purpuric lesions.The common findings,including the positive rates of hyperkeratosis,parakeratosis,and erythrocyte extravasation,were comparable between RCM and histopathological results(P＞0.05).However,the focal acantholysis,liquefaction de-generation of basal cells and intraepidermal blisters in RCM were more common than those in his-topathological examination(P＜0.05).Focal liquefaction degeneration of the basal cell layer was an important distinguishing feature under RCM compared to other diseases.Conclusions Under RCM,childhood pityriasis lichenoides chronica exhibits specific features,some of which have higher detection rates than those of histopathology.RCM can provide a basis for the clinical differ-ential diagnosis of this condition.关键词
慢性苔藓样糠疹/儿童/反射式共聚焦显微镜Key words
pityriasis lichenoides chronica/children/reflectance confocal microscopy
