摘要目的：探讨共聚焦激光扫描显微镜（CLSM）在脂溢性角化病与鲍恩病鉴别中的应用价值。方法选88例临床诊断为脂溢性角化病和18例临床诊断为鲍恩病的患者典型皮损做CLSM检查，然后取该处皮损行组织病理学检查。结果脂溢性角化病CLSM图像特征：全部有表皮脑回状结构，另有角蛋白充填的囊性包裹体，表皮突呈小梁状下延；基底层细胞排列呈条索状或放射状9例，基底层及真皮层可见折光性明亮的结构6例。鲍恩病CLSM图像特征：表皮中下层细胞灶状排列紊乱，体积较大，细胞形态不规则，有明显的异形，真皮浅层散在单个核细胞浸润。结论脂溢性角化病与鲍恩病在CLSM成像上有不同的特征性，CLSM可为二者的鉴别诊断提供帮助。

abstractsObjective To evaluate the application value of confocal laser scanning microscopy(CLSM)in the differentiation between seborrheic keratosis and Bowen′s disease. Methods CLSM was used to observe typical skin lesions in 88 patients clinically diagnosed with seborrheic keratosis and 18 patients clinically diagnosed with Bowen′s disease. Then, tissue specimens were resected from these lesions and subjected to histopathological examination. Results CLSM imaging of seborrheic keratosis lesions showed gyrus?like structures and keratin?filled inclusion cysts in the epidermis with trabecula?like extension of rete ridges in all the 88 cases, basal cells arranged in a cordike or radial pattern in 9 cases, and bright reflective structures in the basal layer and dermis in 6 cases. CLSM imaging of Bowen′s disease lesions revealed disorderly arrangement of large, irregularly shaped atypical cells in some areas in the middle and lower epidermis, and infiltration of scattered mononuclear cells in the superficial dermis. Conclusion CLSM images of seborrheic keratosis are different from those of Bowen′s disease, and CLSM may be helpful for their differential diagnosis.