反射式共聚焦显微镜指导白癜风临床治疗范围
Reflectance Confocal Microscopy Guides the Scope of Clinical Treatment of Vitiligo
DOI: 10.12677/ACM.2023.1391927, PDF,   
作者: 侯永庆：湖北中医药大学第一临床学院，湖北 武汉
关键词: 白癜风；反射式共聚焦显微镜；治疗；Vitiligo； Reflectance Confocal Microscopy； Therapy
摘要: 目的：研究反射式共聚焦显微镜在白癜风诊疗中的应用。方法：利用反射式共聚焦显微镜观察171位我院白癜风患者皮损图像特征，图像中噬黑素细胞及淋巴细胞浸润情况。结果：进展期白癜风皮损边界及皮损内外多可见炎症浸润，稳定期白癜风皮损边界及边界外炎症浸润较少，皮损内未见炎症浸润者较多。对有炎症浸润的皮损区域进行治疗，稳定期皮损内未见炎症浸润者采用围白斑治疗。结论：反射式共聚焦激光扫描显微镜在白癜风的治疗方面应用广泛，能观察白癜风炎症浸润情况并指导白癜风的治疗范围。
Abstract: Objective: To study the application of reflectance confocal microscopy in the diagnosis and treat-ment of vitiligo. Methods: Reflectance confocal microscopy was used to observe the features of skin lesions and the infiltration of melanophages and lymphocytes in 171 patients with vitiligo in our hospital. Results: Inflammatory infiltration was more common in progressive vitiligo than in stable vitiligo. Inflammatory infiltration was more common in stable vitiligo than in progressive vitiligo. The lesions with inflammatory infiltration were treated, and those without inflammatory infiltra-tion in the stable lesions were treated with perileukoplakia. Conclusion: Reflectance confocal laser scanning microscopy is widely used in the treatment of vitiligo, which can observe the inflammatory infiltration of vitiligo and guide the treatment range of vitiligo.
文章引用：侯永庆. 反射式共聚焦显微镜指导白癜风临床治疗范围[J]. 临床医学进展, 2023, 13(9): 13789-13794. https://doi.org/10.12677/ACM.2023.1391927

参考文献

[1] Bergqvist, C. and Ezzedine, K. (2021) Vitiligo: A Focus on Pathogenesis and Its Therapeutic Implications. The Journal of Dermatology, 48, 252-270. [Google Scholar] [CrossRef] [PubMed]
[2] Frączek, A., Kasprowicz-Furmańczyk, M., Placek, W., et al. (2022) Surgical Treatment of Vitiligo. International Journal of Environmental Research and Public Health, 19, Article No. 4812. [Google Scholar] [CrossRef] [PubMed]
[3] Feng, Y.F. and Lu, Y. (2022) Advances in Vitiligo: Update on Therapeutic Targets. Frontiers in Immunology, 13, Article ID: 986918. [Google Scholar] [CrossRef] [PubMed]
[4] 张爱华, 任雁威, 陆星宇, 等. 窄谱中波紫外线围白斑照射治疗难治性白癜风的临床观察[J]. 贵州医药, 2022, 46(12): 1924-1925.
[5] Guo, L.F., Yang, Y., Ding, H., et al. (2022) A Deep Learning-Based Hybrid Artificial Intelligence Model for the Detection and Severity Assessment of Viti-ligo Lesions. Annals of Translational Medicine, 10, 590. [Google Scholar] [CrossRef] [PubMed]
[6] Wang, Y.H., Li, S.L. and Li, C.Y. (2021) Clinical Features, Immuno-pathogenesis, and Therapeutic Strategies in Vitiligo. Clinical Reviews in Allergy & Immunology, 61, 299-323. [Google Scholar] [CrossRef] [PubMed]
[7] Wang, Y.H., Li, S.L. and Li, C.Y. (2021) Correction to: Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo. Clinical Reviews in Allergy & Immunology, 61, 449. [Google Scholar] [CrossRef] [PubMed]
[8] He, Y.M., Li, S.L., Zhang, W.G., et al. (2017) Dysregulated Autophagy Increased Melanocyte Sensitivity to H2O2-Induced Oxidative Stress in Vitiligo. Scientific Reports, 7, Article No. 42394. [Google Scholar] [CrossRef] [PubMed]
[9] Jian, Z., Li, K., Liu, L., et al. (2011) Heme Oxygenase-1 Pro-tects Human Melanocytes from H2O2-Induced Oxidative Stress via the Nrf2-ARE Pathway. Journal of Investigative Dermatology, 131, 1420-1427. [Google Scholar] [CrossRef] [PubMed]
[10] Chen, J.R., Li, S.L. and Li, C.Y. (2021) Mechanisms of Melanocyte Death in Vitiligo. Medicinal Research Reviews, 41, 1138-1166. [Google Scholar] [CrossRef] [PubMed]
[11] Kang, P., Chen, J.R., Zhang, W.G., et al. (2022) Oxeiptosis: A Novel Pathway of Melanocytes Death in Response to Oxidative Stress in Vitiligo. Cell Death Discovery, 8, Article No. 70. [Google Scholar] [CrossRef] [PubMed]
[12] Li, S.L., Zhu, G.N., Yang, Y.Q., et al. (2017) Oxidative Stress Drives CD8(+) T-Cell Skin Trafficking in Patients with Vitiligo through CXCL16 Upregulation by Activating the Unfolded Protein Response in Keratinocytes. Journal of Allergy and Clinical Immunology, 140, 177-189.e9. [Google Scholar] [CrossRef] [PubMed]
[13] Cui, T.T., Zhang, W.G., Li, S.L., et al. (2019) Oxidative Stress-Induced HMGB1 Release from Melanocytes: A Paracrine Mechanism Underlying the Cutaneous Inflammation in Vitiligo. Journal of Investigative Dermatology, 139, 2174-2184.e4. [Google Scholar] [CrossRef] [PubMed]
[14] Chen, X.G., Guo, W.N., Chang, Y.Q., et al. (2019) Oxidative Stress-Induced IL-15 Trans-Presentation in Keratinocytes Contributes to CD8(+) T Cells Activation via JAK-STAT Pathway in Vitiligo. Free Radical Biology and Medicine, 139, 80-91. [Google Scholar] [CrossRef] [PubMed]
[15] 李伟. 反射式共聚焦扫描显微镜在白癜风分期中的应用: 初步研究[D]: [硕士学位论文]. 合肥: 安徽医科大学, 2013.
[16] 刘涛, 许爱娥. 临床特征和皮肤CT特征判定白癜风分期[J]. 中华皮肤科杂志, 2015, 48(6): 404-407.
[17] 王瑞, 王菲菲, 杨俊亚, 等. 皮肤CT在白癜风分期中的应用[J]. 中国CT和MRI杂志, 2018, 16(11): 147-149.
[18] Liu, H.X., Wang, L.L., Lin, Y., et al. (2020) The Differential Diagnosis of Hypopigmented Mycosis Fungoides and Vitiligo with Reflectance Confocal Microscopy: A Preliminary Study. Frontiers in Medicine (Lausanne), 7, Article ID: 609404. [Google Scholar] [CrossRef] [PubMed]
[19] Cortelazzi, C., Pellacani, G., Raposio, E., et al. (2020) Vitiligo Management: Combination of Surgical Treatment and Phototherapy under Reflectance Confocal Microscopy Monitoring. European Review for Medical and Pharmacological Sciences, 24, 7366-7371.
[20] Chuah, S.Y. and Thng, S.T.G. (2019) The Role of in Vivo Reflectance Confocal Microscopy in Assessing the Stability of Vitiligo Vulgaris Prior to Cellular Grafting. Skin Research and Technology, 25, 245-247. [Google Scholar] [CrossRef] [PubMed]
[21] 史赢, 雷铁池. 白癜风皮损复色的细胞与分子机制研究进展[J]. 皮肤科学通报, 2022, 39(4): 271-275.
[22] 陈淑君. 毛发移植对头皮白癜风复色的临床疗效评估及作用机制的研究[D]: [博士学位论文]. 上海: 复旦大学, 2014.
[23] 雷娜, 鲁严. 白癜风光疗研究进展[J]. 皮肤科学通报, 2022, 39(4): 287-293+3.
[24] 张立银. 采用临床特征和皮肤CT特征来判定白癜风分期效果[J]. 影像研究与医学应用, 2020, 4(1): 162-163.
[25] 王改红. 皮肤CT特征对白癜风分期的诊断分析[J]. 皮肤病与性病, 2019, 41(4): 562-563.

为你推荐