鲍文氏病（BD）是一种相对罕见的早期原位鳞状细胞癌，最常见于中老年人，好发于身体各部位的皮肤或粘膜。其起病隐匿，病程慢性，部分患者出现皮外恶性肿瘤；因此，有必要在早期诊断和评估该疾病。本研究旨在探讨反射共聚焦显微镜（RCM）在BD诊断中的应用。我们对92例临床初诊BD患者进行了病灶部位的RCM成像并进行了皮肤活检进行组织学诊断。对RCM结果和组织学检查的回顾性分析显示，分析RCM图像后，在92个活检病灶中，61个诊断为BD，其中54个与RCM诊断一致。经RCM诊断为BD的59例中，54例与组织学诊断相符。随后，我们分析了经活检证实的BD患者的RCM特征，并比较了经典鲍文病和色素性鲍文病两种不同病变的RCM图像，进一步总结了RCM下BD的要点。最后，我们重点讨论了 BD 与 RCM 中其他皮肤病的区别特征。 RCM对于BD的诊断具有重要价值。研究亮点：对临床诊断 BD 患者的 RCM 和组织学诊断进行回顾性研究。分析经活检证实的皮损的RCM特征。 RCM 对 BD 的诊断和鉴别诊断具有重要价值。© 2024 作者。显微镜研究和技术由 Wiley periodicals LLC 出版。

Bowen's disease (BD) is a relatively rare early-stage squamous cell carcinoma in situ, most commonly affecting the middle-aged and elderly, and occurring on the skin or mucous membranes of various parts of the body. Its onset is concealed, the course of the disease is chronic, and some patients have malignant tumors outside the skin; therefore, it is necessary to diagnose and evaluate the disease at an early stage. This study aimed to investigate the application of reflectance confocal microscopy (RCM) in the diagnosis of BD. We performed RCM imaging on the lesion site and underwent skin biopsy for histological diagnosis of 92 patients initially diagnosed with BD in clinic. A retrospective analysis of the RCM result as well as the histological examination revealed that after analyzing RCM images, out of 92 biopsy lesions, 61 were diagnosed with BD, of which 54 were consistent with RCM diagnosis. Among the 59 cases diagnosed with BD by RCM, 54 cases were consistent with the histological diagnosis. Afterwards, we analyzed the RCM characteristics in patients with BD verified by biopsy, and compared the RCM images of two different lesions, classic Bowen's disease and pigmented Bowen's disease, and further summarized the key points of BD under RCM. Finally, we focused on the differential characteristics between BD and other skin diseases in RCM. RCM is of great value in the diagnosis of BD. RESEARCH HIGHLIGHTS: A retrospective study of RCM and histological diagnosis in patients with clinical diagnosis of BD. Analyze the RCM characteristics of skin lesions verified by biopsy. RCM is of great value in the diagnosis and differentiation of BD.© 2024 The Author(s). Microscopy Research and Technique published by Wiley Periodicals LLC.