Significance: Seborrheic keratoses (SKs) are harmless pigmented skin lesions (PSLs) that may be confused clinically not only with other benign conditions but also with cutaneous melanoma (CM). As SKs are one of the most common neoplasms in adults, the importance of their correct diagnosis is high. Misclassifying SK as malignant is not rare and leads to a high number of unnecessary biopsies. On the other hand, misdiagnosing CM as SK may have a large impact on prognosis or therapy. Aim: In the non-invasive technique of dermatofluoroscopy, the fluorophores in melanocytes and keratinocytes are excited in vivo with nanosecond laser pulses and the resulting spectrally resolved, melanin-dominated fluorescence signals are used to differentiate between pigmented benign lesions and CM. Approach: In this single-center, non-interventional study, 33 PSLs of 20 patients were scanned with dermatofluoroscopy in vivo. For all included cases, dermatofluoroscopic signals were compared to pathology classification. Results: The characteristic spectral features of SK were identified, where the signals are dominated by keratin, NAD(P)H, and melanin. The fluorescence spectra of SKs differed substantially from those of CM: a characteristic spectrum of SK has been identified in 27 of 28 SKs. Conclusions: The high-accuracy differential diagnosis between CM and SK is possible with dermatofluoroscopy.

中文翻译：

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黑色素、NAD(P)H 和角蛋白的体内双光子激发细胞荧光可准确鉴别诊断脂溢性角化病和色素性皮肤黑色素瘤

意义：脂溢性角化病 (SK) 是无害的色素性皮肤病变 (PSL)，在临床上不仅可能与其他良性疾病混淆，还可能与皮肤黑色素瘤 (CM) 混淆。由于 SK 是成人中最常见的肿瘤之一，因此正确诊断的重要性很高。将 SK 误分类为恶性的情况并不少见，会导致大量不必要的活检。另一方面，将 CM 误诊为 SK 可能对预后或治疗产生很大影响。目的：在皮肤透视的非侵入性技术中，黑素细胞和角质形成细胞中的荧光团在体内被纳秒激光脉冲激发，产生的光谱分辨的、以黑色素为主的荧光信号用于区分色素性良性病变和 CM。方法：在这项单中心、非干预性研究中，20 名患者的 33 个 PSL 进行了体内皮肤荧光检查。对于所有包括的病例，将皮肤荧光镜信号与病理分类进行比较。结果：确定了 SK 的特征光谱特征，其中信号以角蛋白、NAD(P)H 和黑色素为主。SKs 的荧光光谱与 CM 的荧光光谱有很大不同：在 28 个 SKs 中的 27 个中确定了 SK 的特征光谱。结论： CM 和 SK 之间的高精度鉴别诊断是可能的皮肤荧光镜检查。SKs 的荧光光谱与 CM 的荧光光谱有很大不同：在 28 个 SKs 中的 27 个中确定了 SK 的特征光谱。结论： CM 和 SK 之间的高精度鉴别诊断是可能的皮肤荧光镜检查。SKs 的荧光光谱与 CM 的荧光光谱有很大不同：在 28 个 SKs 中的 27 个中确定了 SK 的特征光谱。结论： CM 和 SK 之间的高精度鉴别诊断是可能的皮肤荧光镜检查。