三色白癜风不同皮损组织激光共聚焦显微镜特征分析

Analysis of Reflectance Confocal Microscopy Characteristics of Different Lesions of Tri-chrome Vitiligo

摘要: 目的：分析三色白癜风皮损在激光共聚焦显微镜下的特征性表现，结合病史及临床特征分析三色白癜风分期。方法：选取武汉市第一医院收治的白癜风患者40例，对患者三色白癜风皮损按照VIDA评分进行分期后，观察其三色白癜风皮损不同色带的RCM图像，并分析总结不同分期的三色白癜风皮损特征性RCM表现。结果：三色白癜风患者并非均处于进展期，不同时期的三色白癜风患者的RCM图像在基底细胞环完整与否、色素颗粒脱失程度、炎症细胞及噬黑素细胞存在与否、边界是否清晰、树突状黑素细胞是否存在这五个方面表现不完全相同，与普通白癜风患者不同分期的RCM图像存在一定程度上的相似，或可以参考现有RCM分期标准对三色白癜风患者进行分期。结论：对于三色白癜风患者应采取病史采集、临床观察、或现有的多种检查方式进行更精确分期，不同分期的三色白癜风患者考虑采取不同治疗方案。

Abstract: Objectives: Analyze the characteristic manifestations of trichrome vitiligo under reflectance confo-cal microscopy, and analyze the staging of trichrome vitiligo based on medical history and clinical features. Methods: 40 trichrome vitiligo patients admitted to Wuhan No. 1 Hospital were retrospec-tively analyzed. After staging the skin lesions of patients with trichrome vitiligo according to the VIDA, observe the RCM images of different color bands in the skin lesions of trichrome vitiligo, ana-lyze and summarize the characteristic RCM manifestations of trichrome vitiligo skin lesions in dif-ferent stages. Results: Not all patients with trichrome vitiligo are in the advanced stage. The RCM images of patients with trichrome vitiligo at different stages exhibit different manifestations in five aspects: completeness of the pigment ring at the basal cell of epidermis, degree of pigment loss, presence of inflammatory cell infiltrates and phagocytic melanocytes, the border of vitiligo lesion clear or not, and the presence of dendritic melanocytes. There is a certain degree of similarity in RCM images between patients with trichrome vitiligo at different stages and those with ordinary vitiligo. Existing RCM staging standards can be referenced to stage patients with trichrome vitiligo. Conclusion: For patients with trichrome vitiligo, medical history collection, clinical features, and multiple existing examination methods should be used for more accurate staging. Patients with trichrome vitiligo at different stages should consider adopting different treatment plans.