[Pulmonary arterial hypertension in collagenoses]

Implications of ultrasound frequency in optoacoustic mesoscopy of the skin

Raster-scan optoacoustic mesoscopy (RSOM) comes with high potential for in vivo diagnostic imaging in dermatology, since it allows for high resolution imaging of the natural chromophores melanin, and hemoglobin at depths of several millimeters. We have applied ultra-wideband RSOM, in the 10-160 MHz frequency band, to image healthy human skin at distinct locations. We analyzed the anatomical information contained at different frequency ranges of the optoacoustic (photoacoustic) signals in relation to resolving features of different skin layers in vivo. We further compared results obtained from glabrous and hairy skin and identify that frequencies above 60 MHz are necessary for revealing the epidermal thickness, a prerequisite for determining the invasion depth of melanoma in future studies. By imaging a benign nevus we show that the applied RSOM system provides strong contrast of melanin-rich structures. We further identify the spectral bands responsible for imaging the fine structures in the stratum corneum, assessing dermal papillae, and resolving microvascular structures in the horizontal plexus.

[Systemic lupus erythematosus. A problem based approach]

Systemic lupus erythematosus (SLE) is a chronic autoinflammatory disease of unknown etiology with predominance of the female sex. Clinical criteria as well as immunological characteristics, e. g. autoantibodies, are necessary for diagnosis. The clinical course of SLE is variable and may be characterized by periods of remissions and chronic or acute relapses. New symptoms are often challenging regarding differential diagnosis. This review will discuss symptoms with a problem based approach. Parameters of activity are helpful to differentiate between disease activity and associated problems, e. g. infections. Lupus patients have a 5 times increased mortality compared to the normal population. The main reasons for mortality are infections and cardiovascular events, rather than disease manifestations. Therefore, besides the fast and precise use of immunosuppressants the consequent therapy of co-morbidities is a major issue in dealing with these patients. Cardiovascular risk factors need to be controlled, life style modifications should be started early, and diagnosis and therapy of osteoporosis should not be neglected.