title: Histological classification of melasma with reflectance confocal microscopy: a pilot study in Chinese patients.
abstract: OBJECTIVE
  To investigate the histological classification of melasma with reflectance confocal microscopy (RCM) in vivo.
  
  
  METHODS
  Two hundred and ten cases with facial melasma lesions were enrolled. After informed consent, the target melasma lesion of 10 patients were imaged with RCM and then biopsied as well. Under the RCM scanning, the distribution of the melanin determined the histological types, and then, the results of RCM images were compared with those of the histopathology. The other 200 cases were tested only with RCM.
  
  
  RESULTS
  For the 10 cases imaged and biopsied, compared with that of the perilesional normal skin, the amount of melanin was significantly increased in the epidermis in all lesions under RCM, while three cases also found melanin in the dermis. Thus, seven of the 10 patients were categorized as the epidermal type while the other three as mixed ones, and the results were well correlated with those of the histopathology. Of the other 200 patients, 143 cases 71.5%) were categorized as the epidermal type while the other 57 (28.5%) cases as mixed ones.
  
  
  CONCLUSIONS
  If more melasma cases are biopsied, the data will be more convincing.
  
  
  CONCLUSIONS
  RCM in vivo analysis shows complete coherence with histopathology results, which could be an alternative for the classification of melasma, and based on the results of RCM imaging, melasma is classified into two major types: the epidermal type and mixed type.
authors.affiliation: Shandong Provincial Institute of Dermatology and Venerelology, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
authors.forename: Huaxu
authors.initials: H
authors.lastname: Liu
authors.forename: Yan
authors.initials: Y
authors.lastname: Lin
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Nie
authors.forename: Shengli
authors.initials: S
authors.lastname: Chen
authors.forename: Xuechao
authors.initials: X
authors.lastname: Chen
authors.forename: Benqing
authors.initials: B
authors.lastname: Shi
authors.forename: Hongqing
authors.initials: H
authors.lastname: Tian
authors.forename: Zhongxiang
authors.initials: Z
authors.lastname: Shi
authors.forename: Meiling
authors.initials: M
authors.lastname: Yu
authors.forename: Dizhan
authors.initials: D
authors.lastname: Zhang
authors.forename: Baoqi
authors.initials: B
authors.lastname: Yang
authors.forename: Guangjin
authors.initials: G
authors.lastname: Wang
authors.forename: Mei
authors.initials: M
authors.lastname: Wu
authors.forename: Furen
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000328:Adult; D044466:Asian People; D001706:Biopsy; D004817:Epidermis / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008543:Melanins / Q000378:metabolism*; D008544:Melanocytes / Q000378:metabolism / Q000473:pathology; D008548:Melanosis / Q000145:classification* / Q000378:metabolism / Q000473:pathology*; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects
chemical_list: D008543:Melanins