A Research On Clinical Significance Of Confocal Laser Scanning Microscopy In Detection Of Dermatic Damage In Psoriasis

Confocal laser scanning microscopy(CLSM) is a dermatic imaging system(dermatic CT), which bases on optical confocal theory and has become a newly rising non-invasive dermatic radiological diagnostic technique. CLSM characterizes as in situ, in vivo, real time and dynamic three dimensions, which can produce real time and dynamic multiple imaging in the same tissue, hence can make diagnosis in the cellular physiology. CLSM can digitalize the dermatic imaging information, produce direct images, make corresponding diagnosis, avoid effect of human factor in the traditional manufacture process of pathological section. Histopathology is the gold standard of diagnosis in dermatologic disease, but biopsy and drawing the materials are invasive, provide limited information from biopsy location, the manufacture of pathological section is time-consuming and exertion, and which has difficulties in accurate measurement of cuticulum thickness.Psoriasis is a immunologic abnormal chronic inflammatory proliferative dermatologic disease, which is determined by polygenic inheritance and irritated and induced by multi environmental factors. Clinical features include argentite scale, membrane and punctate hemorrhage phenomenon. Histopathologic features includes cuticulum parakeratosis with lhyperkeratosis, granular layer decreases or disappears, acanthosis, blood capillary proliferation, extension and permeability increasing in papillary layer of corium, and monocytes infiltrating around blood vessels in superficial layer of corium.Our study utilizes CLSM to research the dermatic structure of healthy and psoriasis people, and compares with histopathologic results, so as to provide theoretical evidence for diagnosis of psoriasis with CLSM.Our study divides into 3 parts. First part, to research the dermatic structure of healthy people with CLSM. The amount of healthy people is 10, whose age ranges from 24 to 30 years old, average age is 27 years old. To obtain the normal CLSM dermatic imaging from skin of forearms or legs. Second part, to research the dermatic imaging of psoriasis people and measure the thickness of cutex with CLSM, every patient skin is divided into normal skin(control group), dermatic damage location(dermatic damage group) and pigmentation location in inconvalescent period(pigmentation group). The measurement index includes length of cuticular process(a), length of subcuticular process(b) and height of dermal papilla(c). The data processing utilizes analysis of variance and Dunnett t test by SPSS 11.0 statistical package. Third part, to compare the CLSM with histopathologic imaging of psoriasis patients and utilizes x~2 test in statistical analysis.In part one, we got normal CLSM dermatic imaging successfully. In part two, we find the thickness of cutex of the dermatic damage group is significantly higher than that of the pigmentation group and control group. CLSM proves stratum spinosum thickening of character in psoriasis and gains psoriasis imaging. In part there, the discovery ratio of tortuosity and extension of dermal papilla blood capillary in psoriasis patients with CLSM is predominantly higher than that with histopathology.Conclusion: CLSM can diagnose psoriasis effectively, which can displace the invasive histopathologic inspection partially. CLSM is a non-invasive, fast and accurate detection method, which is expected in the diagnosis of dermatogic disease.