共焦激光扫描显微镜（CLSM）是一种用于识别和分析皮肤恶性肿瘤的非侵入性技术。多项研究应用CLSM监测基底细胞癌（BCC）的治疗效果。探讨CLSM对低危BCC的诊断价值以及光动力治疗（PDT）的评估。我们使用CLSM诊断了149例BCC患者，组织病理学检查。基于组织病理学，我们总结了低危BCC的分类信息以及通过CLSM观察到的影像学特征。 34 例低危 BCC 患者接受了 PDT 治疗，我们使用 CLSM 评估其疗效。在 149 名参与者中，通过 CLSM 诊断为 BCC，其中 52 例为色素型，87 例为结节型，10 例为浅表型。经组织病理学检查，52例中44例为色素型，5例为结节型，3例为浅表型。 CLSM结果与87例结节型和10例浅表型结果一致。肿瘤周围组织裂隙处可见结节状的CLSM特征，色素团块为色素沉着型的CLSM特征。炎症和血管系统的增加同时发生是浅表的特征。 PDT有效率100%，治愈率67.6%。随访12个月时，PDT复发率为11.8%，结节型15.0%，色素型10.0%，浅表型0%。低危BCC的CLSM组织分型与组织病理学一致。 CLSM 可用于监测 PDT 对低风险 BCC 的疗效。© 作者 2024。由牛津大学出版社代表英国皮肤科医师协会出版。

Confocal laser scanning microscopy (CLSM) is noninvasive technique utilized for identification and analysis skin malignancies. Several studies have applied CLSM in monitoring the therapeutic effects of basal cell carcinoma (BCC).To investigate the diagnostic value of CLSM in low-risk BCC and the evaluation of photodynamic therapy (PDT).We have diagnosed 149 patients with BCC using CLSM and histopathological examination. Based on histopathology, we summarized the classification information of low-risk BCC along with imaging features observed through CLSM. Thirty-four low-risk BCC patients underwent PDT treatment, and we used CLSM to evaluate its efficacy.Out of 149 participants were diagnosed with BCC by CLSM, 52 were pigmented type, 87 were nodular type and 10 were superficial type. After histopathological examination, 44 out of 52 were pigmented type, five were nodular type and three were superficial type. The results of CLSM were consistent with those of 87 nodular type and 10 superficial type. The CLSM features of nodular were observed in the tissue fissures around the tumor, the pigment mass was the CLSM characteristic of pigmented type. The simultaneous occurrence of inflammation and increased vasculature were characteristics of superficial. The effective rate of PDT was 100%, and the cure rate was 67.6%. At 12 months follow up, the recurrence rate of PDT was 11.8%, 15.0% for nodule type, 10.0% for pigmented type and 0% for superficial type.The tissue classification of CLSM for low-risk BCC was consistent with histopathology. CLSM can be used to monitor the efficacy of PDT for low-risk BCC.© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists.