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Ex-vivo konfokale Laserscanmikroskopie bei melanozytären Läsionen und Autoimmunerkrankungen

Ex vivo confocal laser scanning microscopy for melanocytic lesions and autoimmune diseases

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Zusammenfassung

Hintergrund

Die Ex-vivo-KLM (konfokale Laserscanmikroskopie) ermöglicht die Histologie am Krankenbett und bietet dem Chirurgen eine direkte intraoperative Gewebeuntersuchung.

Ziel der Arbeit

Ziel war es herauszufinden, ob dieses innovative, ultraschnelle Diagnoseinstrument neben nichtmelanozytären Hautkrebsformen, insbesondere dem Basalzellkarzinom, auch bei anderen Indikationen, wie melanozytären Läsionen und Autoimmunerkrankungen, nutzbringend eingesetzt werden kann.

Material und Methoden

Literaturbeurteilung und Zusammenfassung der derzeitigen Kenntnisse und Erfahrungen zum Einsatz der Ex-vivo-KLM bei melanozytären Läsionen und bei Autoimmunerkrankungen.

Ergebnisse

Die bisherigen Erfahrungen mit der Anwendung der Ex-vivo-KLM bei melanozytären Läsionen und bei Autoimmunerkrankungen sind begrenzt, zeigen aber vielversprechende Perspektiven. Es werden derzeitige Kenntnisse und Erfahrungen zum Einsatz der Ex-vivo-KLM bei melanozytären Hautveränderungen sowie Beispiele mit den klassischen Ex-vivo-KLM-Merkmalen vorgestellt. Präsentiert werden ferner die bisherigen Ergebnisse zum Einsatz der Ex-vivo-KLM bei entzündlichen Autoimmundermatosen.

Diskussion

Die Methode eignet sich insbesondere zur Schnellschnittuntersuchung von Basalzellkarzinomen während der Mohs-Chirurgie, könnte aber in Zukunft auch bei der intraoperativen Untersuchung von melanozytären Hautveränderungen und Autoimmunerkrankungen eingesetzt werden.

Abstract

Background

Ex vivo confocal laser scanning microscopy (CLSM) enables bedside histology and offers the surgeon a direct intraoperative tissue examination.

Objectives

To determine whether this innovative, ultra-fast diagnostic tool can be expanded beyond nonmelanoma skin cancer, particularly basal cell carcinoma, to other indications including melanocytic lesions and autoimmune diseases.

Materials and methods

Review of literature and summary of the current knowledge and experience of the use of ex vivo CLSM in melanocytic lesions and in autoimmune diseases.

Results

Up to date experience of the use of ex vivo CLSM in melanocytic lesions and in autoimmune diseases is limited but promising. Current knowledge on melanocytic lesions in ex vivo CLSM and their examples together with classic ex vivo CLSM features are presented. Previous results on the use of ex vivo CLSM in autoimmune dermatoses are presented, and future application possibilities of ex vivo CLSM are discussed.

Conclusions

The method is particularly suitable for the rapid examination of basal cell carcinomas during Mohs surgery but could also be used in the future for the intraoperative examination of melanocytic and autoimmune skin lesions.

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  1. Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9–11, 80337, München, Deutschland

    D. Hartmann Ph.D.

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Hartmann, D. Ex-vivo konfokale Laserscanmikroskopie bei melanozytären Läsionen und Autoimmunerkrankungen. Hautarzt 72, 1058–1065 (2021). https://doi.org/10.1007/s00105-021-04906-1

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