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目的:分析黑棘皮病皮肤镜和反射式共聚焦显微镜（RCM）特征，探讨皮肤镜和RCM对黑棘皮病的辅助诊断价值。方法:收集2018年1月至2019年12月在杭州市第三人民医院皮肤科门诊就诊的黑棘皮病患者63例，选取5例健康个体作为对照，采用皮肤镜及RCM检查每例患者的颈部和腋下2处皮损。对3例患者在观察部位取材并进行常规的组织病理检查。结果:皮肤镜显示，126处（100%）皮损可见乳头瘤样增生，119处（94.4%）可见胖手指结构，120处（95.2%）可见沟壑结构。RCM检查显示，126处（100%）皮损可见基底层色素增加、乳头环下延扭曲及沟壑结构，87处（69.0%）皮损在乳头环内可见中高折光颗粒结构。结论:黑棘皮病有典型的皮肤镜及RCM特征，可为其诊断及鉴别诊断提供依据。“,”Objective:To analyze dermoscopic and reflectance confocal microscopic characteristics of acanthosis nigricans, and to assess the value of dermoscopy and reflectance confocal microscopy (RCM) in the auxiliary diagnosis of acanthosis nigricans.Methods:A total of 63 patients with acanthosis nigricans were collected from Department of Dermatology, the Third People′s Hospital of Hangzhou from January 2018 to December 2019, and 5 healthy individuals served as controls. Two lesions on the neck and axilla were examined with dermoscopy and RCM separately in each patient. Biopsies were carried out at the sites evaluated by dermoscopy and RCM in 3 patients, followed by routine histopathological examination.Results:Dermoscopy showed papilloma-like hyperplasia in 126 (100%) lesions, “fat finger” structures in 119 (94.4%) , and “gully” structures in 120 (95.2%) . RCM showed hyperpigmentation in the basal layers, downward extension and twisting of dermal papillary rings and “gully” structures in 126 (100%) lesions, moderately to highly refractive particles in the dermal papillary rings in 87 (69.0%) .Conclusion:Acanthosis nigricans has typical dermoscopic and reflectance confocal microscopic characteristics, which can provide a basis for its diagnosis and differential diagnosis.