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In-vivo-konfokale Laserscanmikroskopie: Diagnostische Kriterien für die Differenzierung vesikulöser/ bullöser Dermatosen

Morphologic criteria of vesiculobullous skin disorders by in vivo reflectance confocal microscopy

Samhaber, Kinga
Doctoral thesis
Date of Examination: 2016-11-16
Date of issue: 2016-11-09
Advisor: Hänßle, Holger PD Dr.
Referee: Hänßle, Holger PD Dr.
Referee: Becker, Jürgen PD Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-002B-7C9B-7

 

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Abstract

English

Background and Objectives: Reflectance confocal microscopy (RCM) may aid an accurate, rapid, and non-invasive diagnosis of vesiculobullous skin diseases (VSD) at bedside. The main outcome measure of this study was a descriptive statistical analysis of RCM features associated with selected VSD. Patients and Methods: Single-center, observational study at a university-based dermatology department. Forty skin lesions in 24 patients with bullous pemphigoid (BP), varicella zoster infection (VZI), or allergic contact dermatitis (ACD) were assessed. Results: Patients with BP, VZI, and ACD were assessed for presence of a large panel of RCM features including, among others, histopathologic correlates for spongiosis, vesicles/bullae, epidermal necrosis, pleomorphic ballooned keratinocytes, and inflammatory infiltrate. The three conditions showed distinct patterns for the presence of RCM features. Using a multivariate regression model, we identified sets of morphologic features in BP (vesicles/bullae at the dermo-epidermal junction, inflammatory infiltrate within bullae and basal epidermal layers, spongiosis in basal epidermal layers), VZI (acantholysis in the stratum spinosum, epidermal necrosis, pleomorphic ballooned keratinocytes, multinucleated giant cells), and ACD (microvesicles, spongiosis, and prominent inflammatory infiltrate in the stratum granulosum/spinosum). Conclusions: RCM seems to be a useful tool in the evaluation and differentiation of a selected group of VSD, and offers a good correlation with histopathological findings.
Keywords: reflectance confocal microscopy; bullous pemphigoid; varicella zoster infection; allergic contact dermatitis
Schlagwörter: konfokale Laserscanmikroskopie; Varizella zoster; allergische Kontaktdermatitis; bullöses Pemphigoid
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