| Confocal laser scanning microscopy (CLSM), a dermatic imaging system, which is based on confocal theory, combines optical microscopy, laser scanning, and computer image programming technique together. This new machine consists of laser light source, confocal system, and computer system. CLSM has already become a newly rising noninvasive dermatic radiological examination diagnostic technique, which is also called Dermatic CT. This brand new microscopy grows more mature with the development of laser, video, and computer technique. CLSM characterizes as in situ, in vivo, real time and dynamic three dimensions. Its noninvasive properties along with in vivo avoid effect of human factor in the traditional manufacture process of pathological section during dermatic radiological diagnosis, which makes the results more objective.Psoriasis, common reddish scaling disease in dermatology, is related to polygenic inheritance and immunologic abnormal, often company with chronic inflammatory and proliferation, sometimes itchy or aching, clinical features include argentite scale based on reddish skin, membrance, and auspitz’s sign. Histopathological features include cuticulum parakeratosis with hyperkeratosis, 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.This research utilizes CLSM to observe the dermatic structure of damage location from different TCM syndrome types to achieve typical CLSM imaging, so as to provide theoretical evidence for more accurate TCM discrimination and following symptomatic treatment according to the summary of different features of CLSM imaging of distinct TCM syndrome types.The research divides into three parts. First, to observe the dermatic structure of healthy people with CLSM.15 healthy volunteers, whose age ranges from 21 to 40 years old, average age is 30 years old. Obtain normal CLSM dermatic imaging from skin of forearms or legs. Second, to research the dermatic imaging of psoriasis people and take down the statistic. Third, divide patients in blood-heat syndrome, blood-dry syndrome, and blood-stasis syndrome according to the result of comprehensive analysis by the four examination methods. Analyze the CLSM features of different TCM syndrome types with SPSS 20.0.We get normal CLSM imaging successfully in part one. In part two, we conclude the feature of psoriasis CLSM imaging:cuticalum parakeratosisi with (or) hyperkeratosis, Munro microabscess, extension in papillary layer of corium, blood capillary proliferation, the growth model of psoriasis, the basal layer of pigment loss or decreases, granular layer deceases or disappears, acanthosis, dermatic inflammatory cell infiltration, the inflammatory cells scattered into epidermis. In part three, different TCM syndrome types has its own distinguishing feature can be concluded. The feature of blood-heat syndrome consists of blood capillary proliferation (88.9%), Munro microabscess (86.1%), and extension in papillary layer of corium (86.1%). The feature of blood-dryness syndrome consists of parakeratosis (75%), hyperkeratosis (75%), and blood capillary proliferation (75%). The feature of blood-stasis syndrome consists of blood capillary proliferation (100%), Munro microabscess (85.7%), and hyperkeratosis (85.7%).Conclusion:CLSM can diagnose psoriasis effectively, which can displace the invasive histopathology inspection partially. CLSM can make more accurate TCM discrimination, which is beneficial to reduce the rate of misdiagnosis, specific following symptomatic treatment, and improve the efficiency of clinical treatment. CLSM examination is a in situ, noninvasive, in vivo, convenient, and accurate examination method, which has great expectation in the diagnosis of dermatic disease. |
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