1
|
Perino F, Suarez R, Perez-Anker J, Carrera C, Rezze GG, Primiero CA, Alos LL, Díaz A, Barreiro A, Puig S, Peris K, Malvehy J. Concordance of in vivo reflectance confocal microscopy and horizontal-sectioning histology in skin tumours. J Eur Acad Dermatol Venereol 2024; 38:124-135. [PMID: 37669864 DOI: 10.1111/jdv.19491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/19/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND In vivo reflectance confocal microscopy (RCM) enables the study of architectural and cytological aspects in horizontal sections, which closely correlate with histologic features. However, traditional histopathological vertical sections cannot totally reproduce the image of the in vivo RCM horizontal section. OBJECTIVE To evaluate the concordance between in vivo RCM and histopathologic transverse sections for melanocytic lesions, basal cell carcinoma and seborrheic keratoses. METHODS Prospectively collected benign melanocytic and non-melanocytic tumours diagnosed by dermoscopy were evaluated for common RCM features and compared to histopathology in horizontal sections with haematoxylin and eosin staining. RESULTS A total of 44 skin tumours including 19 melanocytic lesions (nine compound, five junctional and five intradermal nevi), 12 basal cell carcinomas and 13 seborrheic keratoses were collected in the Department of Dermatology of Hospital Clinic of Barcelona. The RCM features that had statistically significant agreement with the histopathological horizontal sections were the preserved and visible honeycomb pattern, well defined DEJ, small bright particles, dermal nests, tumour islands and dark silhouettes, clefting, collagen bundles, thickened collagen bundles and cytologic atypia. CONCLUSIONS Histopathology evaluation of horizontal sections of skin tumours can be correlated with main RCM findings. The results of this study have improved the understanding and interpretation of RCM features in relation to skin tumours, thus reinforcing the utility of RCM as a diagnostic tool.
Collapse
Affiliation(s)
- F Perino
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - R Suarez
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - J Perez-Anker
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Medicine Department, University of Barcelona, Barcelona, Spain
| | - C Carrera
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Medicine Department, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salut Carlos III, Barcelona, Spain
| | - G G Rezze
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - C A Primiero
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Dermatology Research Centre, The University of Queensland Frazer Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - L L Alos
- Medicine Department, University of Barcelona, Barcelona, Spain
- Pathology Department, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Díaz
- Medicine Department, University of Barcelona, Barcelona, Spain
- Pathology Department, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Barreiro
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - S Puig
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Medicine Department, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salut Carlos III, Barcelona, Spain
| | - K Peris
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - J Malvehy
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Medicine Department, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salut Carlos III, Barcelona, Spain
| |
Collapse
|
2
|
Scharf C, Di Brizzi EV, Licata G, Piccolo V, Argenziano G, Moscarella E. Reflectance confocal microscopy in paediatric patients: Applications and limits. Exp Dermatol 2023; 32:210-213. [PMID: 36264215 DOI: 10.1111/exd.14691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/26/2022] [Accepted: 10/18/2022] [Indexed: 11/30/2022]
Abstract
Reflectance confocal microscopy (RCM) is a non-invasive diagnostic tool extensively studied for adult patients. In this retrospective case series conducted at the Dermatology Unit of the University of Campania, Naples, Italy, all patients under 19 years old who were submitted to RCM from January 2011 to December 2021 where evaluated. The aim of the study was to review the most usual indications and possible benefits that it might add for children. Data collection included 215 patients (86 males and 129 females, mean age: 12). Most of the exams (n = 85; 39.5%) were performed for lesions clinically compatible with Spitz nevi, congenital nevi (n = 50 23,2%) and atypical melanocytic lesions (n = 46; 21%) among which two melanomas were detected. RCM can be an useful instrument when evaluating paediatric patients and may help avoid unnecessary biopsy in most cases, representing an additional instrument to improve diagnostic accuracy.
Collapse
Affiliation(s)
- Camila Scharf
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
| | | | - Gaetano Licata
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Vincenzo Piccolo
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
| | | | - Elvira Moscarella
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
| |
Collapse
|
3
|
Reflectance Confocal Microscopy for Identification of Vulvar Lichen Sclerosus et Atrophicus and Vitiligo. Am J Dermatopathol 2022; 44:867-873. [DOI: 10.1097/dad.0000000000002269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
4
|
Huang Y, He J, Zhang S, Tang Y, Wang B, Jian D, Xie H, Li J, Chen F, Zhao Z. A novel multi-layer perceptron model for assessing the diagnostic value of non-invasive imaging instruments for rosacea. PeerJ 2022; 10:e13917. [PMID: 35996670 PMCID: PMC9392450 DOI: 10.7717/peerj.13917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/28/2022] [Indexed: 01/19/2023] Open
Abstract
Background Reflectance confocal microscopy (RCM), VISIA, and dermoscopy have emerged as promising tools for objective diagnosis and assessment of rosacea. However, little is known about the diagnostic value of these imaging systems for rosacea. Objectives To assess the diagnostic value of RCM, VISIA, and dermoscopy for rosacea by establishing a novel multilayer perceptron (MLP) model. Methods A total of 520 patients with rosacea and other facial diseases were included in this study. A total of 474 samples of dermoscopy data, 374 samples of RCM data, 434 samples of VISIA data, and 291 samples containing three data sources were collected. An MLP model was built with the total data to explore the association between the imageological features of each instrument and the probability of rosacea. Results Our MLP model revealed that the area under the receiver operating characteristic curve (AUROC) values of RCM, VISIA and dermoscopy for diagnosing rosacea were 0.5233, 0.5646 and 0.7971, respectively. The integration of these three tools with clinical data could further improve the accuracy of the predictive diagnosis to 0.8385. For the imageological features of each tool, abnormalities (hyperkeratosis or parakeratosis) in the stratum corneum were effective variables for excluding rosacea (odds ratio [OR], 0.4333) under RCM. The indicators of rosacea under VISIA included overall severity of erythema, erythema involving the cheek or superciliary arch, visible red blood vessels, and papules (OR = 2.2745, 3.1592, 1.8365, 2.8647, and 1.4260, respectively). The candidate variables of dermoscopy included yellow background, white background, uniform distribution of vessels, branched vessels, and reticular blood vessels (OR = 0.4259, 0.4949, 2.2858, 3.7444, and 2.4576, respectively). Conclusions RCM, dermoscopy, and VISIA each can present several imageological features and were of certain value for assisting rosacea diagnosis. The combined analysis of these three tools using our MLP model may be useful for improving the accuracy of diagnosing rosacea.
Collapse
Affiliation(s)
- Yingxue Huang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jieyu He
- School of Public Health, Kunming Medical University, Kuming, Yunnan, China
| | - Shuping Zhang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yan Tang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ben Wang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Dan Jian
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hongfu Xie
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Feng Chen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhixiang Zhao
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| |
Collapse
|
5
|
Lateral Circumflex Femoral Vascular Chimeric Fascia Flap Reduces Pain and Promotes Wound Healing in Repairing Skin and Tendon Defects of Hand, Foot, and Ankle. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:2874332. [PMID: 35992542 PMCID: PMC9356846 DOI: 10.1155/2022/2874332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to investigate the clinical efficacy of lateral circumflex femoral artery embedded with fascia lata flap in the repair of skin and tendon defects in hand, foot, and ankle. From January 2020 to June 2021, 32 patients with skin and tendon defects of the hand, foot, and ankle admitted to our hospital were selected as the study subjects. According to the random number table method, they were divided into the observation group (16 cases, treated with rotational lateral femoral vascular inlay broad fascial flap repair) and the control group (16 cases, treated with conventional skin flap repair) and followed up for 6 months. The postoperative tendon midactivity measurement scale (TAM), ankle-hindfoot scoring system (AOFAS), and lower limb functional evaluation scale (LEFS) scores were all higher in the observer group than in the control group The number of people with infection, implant necrosis, and subcutaneous hematoma in the observation group (total incidence 6.25%) was less (lower) than that in the control group (50.00%), and the total number of people with significant and fair clinical efficacy in the observation group (total effective rate 100.00%) was more (higher) than that in the control group (68.75%). The application of early plastic surgery to the clinical treatment of patients with deep burns on the hand can reduce the patient's pain and promote the healing of the wound. It is of great significance to reduce the risk of complications such as necrosis of the skin graft and improve the efficacy of the surgery.
Collapse
|
6
|
Zhao J, Kulkarni N, Dobo E, Khan MJ, Yang E, Kang D. Investigation of different wavelengths for scattering-based light sheet microscopy. BIOMEDICAL OPTICS EXPRESS 2022; 13:3882-3892. [PMID: 35991931 PMCID: PMC9352285 DOI: 10.1364/boe.459823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/19/2022] [Accepted: 06/07/2022] [Indexed: 05/30/2023]
Abstract
Scattering-based light sheet microscopy (sLSM) is a microscopy technique that can visualize cellular morphologic details based on the scattering signal. While sLSM was previously shown to image animal tissues ex vivo at a cellular resolution, the wavelength used was chosen based on other in vivo microscopy technologies rather than through a comparison of the sLSM imaging performance between different wavelengths. In this paper, we report the development of a multi-wavelength sLSM setup that facilitates the investigation of different wavelengths for sLSM imaging. Preliminary results of imaging human anal tissues ex vivo showed that the sLSM setup allowed for comparisons of the cellular imaging performance at the same tissue location between different wavelengths. Both the quantitative analysis of the image contrast and the visual assessment by a pathologist showed that the imaging depth increased with wavelength, and the imaging depth increase was most notable around 600 nm. The preliminary results showed that the multi-wavelength sLSM setup could be useful in identifying the optimal wavelength for the specific tissue type.
Collapse
Affiliation(s)
- Jingwei Zhao
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Nachiket Kulkarni
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Erika Dobo
- School of Medicine, Stanford University, Stanford, California 94305, USA
| | - Michelle J. Khan
- School of Medicine, Stanford University, Stanford, California 94305, USA
| | - Eric Yang
- School of Medicine, Stanford University, Stanford, California 94305, USA
| | - Dongkyun Kang
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| |
Collapse
|
7
|
Sun N, Bruce AC, Ning B, Cao R, Wang Y, Zhong F, Peirce SM, Hu S. Photoacoustic microscopy of vascular adaptation and tissue oxygen metabolism during cutaneous wound healing. BIOMEDICAL OPTICS EXPRESS 2022; 13:2695-2706. [PMID: 35774317 PMCID: PMC9203110 DOI: 10.1364/boe.456198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 06/15/2023]
Abstract
Cutaneous wounds affect millions of people every year. Vascularization and blood oxygen delivery are critical bottlenecks in wound healing, and understanding the spatiotemporal dynamics of these processes may lead to more effective therapeutic strategies to accelerate wound healing. In this work, we applied multi-parametric photoacoustic microscopy (PAM) to study vascular adaptation and the associated changes in blood oxygen delivery and tissue oxygen metabolism throughout the hemostasis, inflammatory, proliferation, and early remodeling phases of wound healing in mice with skin puncture wounds. Multifaceted changes in the vascular structure, function, and tissue oxygen metabolism were observed during the 14-day monitoring of wound healing. On the entire wound area, significant elevations of the arterial blood flow and tissue oxygen metabolism were observed right after wounding and remained well above the baseline over the 14-day period. On the healing front, biphasic changes in the vascular density and blood flow were observed, both of which peaked on day 1, remained elevated in the first week, and returned to the baselines by day 14. Along with the wound closure and thickening, tissue oxygen metabolism in the healing front remained elevated even after structural and functional changes in the vasculature were stabilized. On the newly formed tissue, significantly higher blood oxygenation, flow, and tissue metabolism were observed compared to those before wounding. Blood oxygenation and flow in the new tissue appeared to be independent of when it was formed, but instead showed noticeable dependence on the phase of wound healing. This PAM study provides new insights into the structural, functional, and metabolic changes associated with vascular adaptation during wound healing and suggests that the timing and target of vascular treatments for wound healing may affect the outcomes.
Collapse
Affiliation(s)
- Naidi Sun
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Anthony C. Bruce
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA
| | - Bo Ning
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA
| | - Rui Cao
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA
| | - Yiming Wang
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA
| | - Fenghe Zhong
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Shayn M. Peirce
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA
| | - Song Hu
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA
| |
Collapse
|
8
|
Tools of dermatology: A historical perspective. Clin Dermatol 2021; 39:555-562. [PMID: 34809761 DOI: 10.1016/j.clindermatol.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Dermatology is one of the few visual specialties; much can be seen with the naked eye, yet many tools and devices can facilitate the diagnosis of cutaneous maladies. There has been significant progress in diagnostic techniques in recent decades with the advent of artificial intelligence and teledermatology. Such advancements reflect principles of long-standing aids, whereas others embody novel techniques and concepts. These bedside tools range from simple magnifiers and binocular loupes to reflectance confocal microscopes and ultrasounds. The cornerstone diagnostic techniques, including the potassium hydroxide examination and the Tzanck smear, remain highly useful. Although visual examination often permits an accurate diagnosis of a skin disease, the clinician is now even further equipped. Just as the microscope did 4 centuries ago, newer advances will continue to revolutionize the practice of medicine.
Collapse
|
9
|
Romano A, Di Stasio D, Petruzzi M, Fiori F, Lajolo C, Santarelli A, Lucchese A, Serpico R, Contaldo M. Noninvasive Imaging Methods to Improve the Diagnosis of Oral Carcinoma and Its Precursors: State of the Art and Proposal of a Three-Step Diagnostic Process. Cancers (Basel) 2021; 13:cancers13122864. [PMID: 34201237 PMCID: PMC8228647 DOI: 10.3390/cancers13122864] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Oral squamous cell carcinoma (OSCC) accounts for 90–95% of malignant tumors of the lip and oral cavity and is associated with high mortality in the advanced stages. Early diagnosis is a challenge for oral pathologists and dentists, due to the ambiguous appearance of early OSCC, which is often misdiagnosed, mistreated, and associated with diagnostic delay. The gold standards for OSCC diagnosis are biopsy and histopathological assessment, but these procedures are invasive and time-consuming. Adjunctive noninvasive techniques allow the definition of the malignant features of a suspicious lesion in real time and noninvasively, thus improving the diagnostic procedure. The present review aimed to focus on some of the main promising noninvasive imaging techniques, to highlight their perspective adoption in a three-step diagnosis, which is idealistically faster and better, as well as enables the patient’s compliance. Abstract Oral squamous cell carcinoma (OSCC) is the most prevalent form of cancer of lips and oral cavity, and its diagnostic delay, caused by misdiagnosis at the early stages, is responsible for high mortality ratios. Biopsy and histopathological assessment are the gold standards for OSCC diagnosis, but they are time-consuming, invasive, and do not always enable the patient’s compliance, mainly in cases of follow-up with the need for more biopsies. The use of adjunctive noninvasive imaging techniques improves the diagnostic approach, making it faster and better accepted by patients. The present review aims to focus on the most consolidated diagnostic techniques, such as vital staining and tissue autofluorescence, and to report the potential role of some of the most promising innovative techniques, such as narrow-band imaging, high-frequency ultrasounds, optical coherence tomography, and in vivo confocal microscopy. According to their contribution to OSCC diagnosis, an ideal three-step diagnostic procedure is proposed, to make the diagnostic path faster, better, and more accurate.
Collapse
Affiliation(s)
- Antonio Romano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy;
| | - Fausto Fiori
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Carlo Lajolo
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli–IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy;
| | - Andrea Santarelli
- Department of Clinical Specialist and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy;
| | - Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
- Correspondence: ; Tel.: +39-3204876058
| |
Collapse
|
10
|
Guerraty M, Bhargava A, Senarathna J, Mendelson AA, Pathak AP. Advances in translational imaging of the microcirculation. Microcirculation 2021; 28:e12683. [PMID: 33524206 PMCID: PMC8647298 DOI: 10.1111/micc.12683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/18/2021] [Accepted: 01/26/2021] [Indexed: 12/21/2022]
Abstract
The past few decades have seen an explosion in the development and use of methods for imaging the human microcirculation during health and disease. The confluence of innovative imaging technologies, affordable computing power, and economies of scale have ushered in a new era of "translational" imaging that permit us to peer into blood vessels of various organs in the human body. These imaging techniques include near-infrared spectroscopy (NIRS), positron emission tomography (PET), and magnetic resonance imaging (MRI) that are sensitive to microvascular-derived signals, as well as computed tomography (CT), optical imaging, and ultrasound (US) imaging that are capable of directly acquiring images at, or close to microvascular spatial resolution. Collectively, these imaging modalities enable us to characterize the morphological and functional changes in a tissue's microcirculation that are known to accompany the initiation and progression of numerous pathologies. Although there have been significant advances for imaging the microcirculation in preclinical models, this review focuses on developments in the assessment of the microcirculation in patients with optical imaging, NIRS, PET, US, MRI, and CT, to name a few. The goal of this review is to serve as a springboard for exploring the burgeoning role of translational imaging technologies for interrogating the structural and functional status of the microcirculation in humans, and highlight the breadth of current clinical applications. Making the human microcirculation "visible" in vivo to clinicians and researchers alike will facilitate bench-to-bedside discoveries and enhance the diagnosis and management of disease.
Collapse
Affiliation(s)
- Marie Guerraty
- Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,
USA
| | - Akanksha Bhargava
- Russell H. Morgan Department of Radiology and Radiological
Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Janaka Senarathna
- Russell H. Morgan Department of Radiology and Radiological
Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Asher A. Mendelson
- Department of Medicine, Section of Critical Care, Rady
Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Arvind P. Pathak
- Russell H. Morgan Department of Radiology and Radiological
Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Biomedical Engineering, The Johns Hopkins
University School of Medicine, Baltimore, MD, USA
- Department of Electrical Engineering, Johns Hopkins
University, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, The Johns
Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
11
|
Pérez-Anker J, Toll A, Puig S, Malvehy J. Six steps to reach optimal scanning in ex vivo confocal microscopy. J Am Acad Dermatol 2021; 86:188-189. [PMID: 33476729 DOI: 10.1016/j.jaad.2021.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Javiera Pérez-Anker
- Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunye, Universitat de Barcelona, Barcelona, Spain.
| | - Agustí Toll
- Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunye, Universitat de Barcelona, Barcelona, Spain
| | - Susana Puig
- Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunye, Universitat de Barcelona, Barcelona, Spain
| | - Josep Malvehy
- Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunye, Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
12
|
Fried L, Tan A, Bajaj S, Liebman TN, Polsky D, Stein JA. Technological advances for the detection of melanoma. J Am Acad Dermatol 2020; 83:983-992. [DOI: 10.1016/j.jaad.2020.03.121] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 03/02/2020] [Accepted: 03/22/2020] [Indexed: 10/24/2022]
|
13
|
Shahriari N, Grant-Kels JM, Rabinovitz H, Oliviero M, Scope A. Reflectance confocal microscopy: Principles, basic terminology, clinical indications, limitations, and practical considerations. J Am Acad Dermatol 2020; 84:1-14. [PMID: 32553679 DOI: 10.1016/j.jaad.2020.05.153] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 12/24/2022]
Abstract
Reflectance confocal microscopy (RCM) is a noninvasive imaging tool used for in vivo visualization of the skin. It has been extensively studied for use in the evaluation of equivocal cutaneous neoplasms to decrease the number of biopsy procedures in patients with benign lesions. Furthermore, its applications are broadening to include presurgical cancer margin mapping, tumor recurrence surveillance, monitoring of ablative and noninvasive therapies, and stratification of inflammatory disorders. With the approval of category I Current Procedural Terminology reimbursement codes for RCM image acquisition and interpretation, use of this technology has been increasingly adopted by dermatologists. The first article in this 2-part continuing medical education series highlights basic terminology, principles, clinical applications, limitations, and practical considerations in the clinical use of RCM technology.
Collapse
Affiliation(s)
- Neda Shahriari
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut; Department of Dermatology, University of Florida, Gainesville, Florida
| | - Harold Rabinovitz
- Skin and Cancer Associates, Plantation, Florida; Dermatology Department, Medical College of Georgia at Augusta University, Augusta, Georgia
| | | | - Alon Scope
- The Kittner Skin Cancer Screening and Research Institute, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Dermatology Service, Memorial Sloan-Kettering Center, New York, New York
| |
Collapse
|
14
|
Menzinger S, Saurat JH, Kaya G. Morphological Analysis of Dermatoporosis by in vivo Reflectance Confocal Microscopy and Ultrasonography. Dermatopathology (Basel) 2020; 6:279-287. [PMID: 32309277 PMCID: PMC7154283 DOI: 10.1159/000505990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/14/2020] [Indexed: 12/03/2022] Open
Abstract
Background Dermatoporosis is defined as a chronic cutaneous fragility and insufficiency syndrome. It results from chronological aging, long-term and unprotected sun exposure, genetic factors, or the chronic use of topical and systemic corticosteroids. There is currently a lack of noninvasive tools for the evaluation and quantification of dermatoporosis. Objectives The aim of this study was to define the dermal-epidermal modifications which characterize dermatoporosis using noninvasive methods such as in vivo reflectance confocal microscopy (RCM) and ultrasound (US). Subjects and Methods Seventeen patients with stage I dermatoporosis and 14 healthy volunteers were included in the study. The posterior surface of the right forearm was analyzed in all subjects, and stellate pseudoscars and senile purpura in patients with dermatoporosis were analyzed when possible. We used a commercially available reflectance confocal microscope and measured different histometric parameters (thickness of the epidermis and its different layers, cellular architecture, aspect of the dermal-epidermal junction and the dermis). We also used a commercially available US skin system to define the dermal-epidermal thickness (DET) in all subjects. Results The DET measured with the US skin system was significantly different between the two groups: mean value 1.19 mm (volunteers group) versus 0.81 mm (patient group). The significant differences measured with RCM were (1) epidermal thickness, (2) number of dermal papillae, and (3) thickness of solar elastosis. Stellate pseudoscars are also characterized by a modified dermis, with a linear organization of the collagen bundles. Conclusion US and in vivo RCM are useful tools for the diagnosis of dermatoporosis. Dermal-epidermal atrophy, reduction of dermal papillae/area, and the thickness of dermal elastosis seem to be the major histometric parameters which characterize dermatoporosis.
Collapse
Affiliation(s)
- Sébastien Menzinger
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
| | - Jean-Hilaire Saurat
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - Gürkan Kaya
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
| |
Collapse
|
15
|
Piraccini BM, Granger C, Alessandrini A, Brandi N, Bruni F, Mandel VD, Pellacani G, Starace M. Clinical and Instrumental Objective Evidence of the Efficacy of a New Water-Based Nail-Strengthening Solution Containing Pistacia lentiscus and Hyaluronic Acid Applied for Up to 6 Months to Improve the Appearance of Weak, Brittle Nails. Dermatol Ther (Heidelb) 2020; 10:119-131. [PMID: 31749090 PMCID: PMC6994637 DOI: 10.1007/s13555-019-00343-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Brittle nails are fragile or split nails; they affect 20% of the population and may be primary or secondary to different conditions. The aim of our studies was to evaluate the efficacy and tolerability of a new water-based nail-strengthening treatment containing hyaluronic acid and Pistacia lentiscus with daily application for a period of 1-3 months for one study (n = 30) and up to 6 months for a second study (n = 30). METHODS In total, we enrolled 60 patients of both sexes with brittle and weak nails due to primary or secondary causes and evaluated the efficacy of this new product using subjective and objective methods: clinical evaluation, assessment of photographs, onychoscopy evaluation, investigator and patient global assessment, dynamic optical coherence tomography (D-OCT) and reflectance confocal microscopy (RCM). RESULTS Studies subjects presented a statistically significant improvement in global assessment scale (GAS) scores at 14 days (GAS = 1.7 ± 0.6), 1 month (GAS = 1.4 ± 0.7) and at 3 months (GAS = 1±0.7) versus the GAS score obtained before treatment (1.9 ± 0.5) (p < 0.0001). From the Italian study at 6 months (n = 30) 76% of the patients had an improvement in their nail appearance. Reduction in nail plate roughness with improved nail resistance and decreased distal breakage were the most evident benefits, demonstrated on clinical and instrumental evaluations. No side effects were reported. All patients reported an improvement in nail appearance after using the product for 1 month, 3 months and 6 months, and had a positive opinion on the product. CONCLUSIONS This new product is an effective, safe, and easy-to-use option for topical treatment of brittle nails and primary nail fragility and an adjuvant therapy in secondary nail fragility. Moreover, its ease of application and cosmetic qualities allow good compliance. FUNDING ISDIN.
Collapse
Affiliation(s)
- Bianca Maria Piraccini
- Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy.
| | | | - Aurora Alessandrini
- Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
| | - Nicolò Brandi
- Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
| | - Victor Desmond Mandel
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Michela Starace
- Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
| |
Collapse
|
16
|
Ionescu AM, Ilie MA, Chitu V, Razvan A, Lixandru D, Tanase C, Boda D, Caruntu C, Zurac S. In vivo Diagnosis of Primary Cutaneous Amyloidosis -the Role of Reflectance Confocal Microscopy. Diagnostics (Basel) 2019; 9:diagnostics9030066. [PMID: 31252549 PMCID: PMC6787715 DOI: 10.3390/diagnostics9030066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 12/12/2022] Open
Abstract
Primary cutaneous amyloidosis (PCA) is a form of localized amyloidosis. It is characterized by the deposition of a fibrillar material in the superficial dermis, without affecting other systems or organs. The diagnosis can be made clinically, but usually a skin biopsy is performed in order to exclude other skin diseases with similar appearance. Reflectance confocal microscopy (RCM) is a novel imaging tool that enables in vivo characterization of various skin changes with a high, quasi-microscopic resolution. This technique might have an important role in the differential diagnosis of cutaneous amyloidosis, by the in vivo assessment of epidermal changes and dermal amyloid deposition. Moreover, it is completely non-invasive and can be safely repeated on the same skin area. However, to date, there is only one published paper presenting the confocal features of primary cutaneous amyloidosis. Hereby, we describe the in vivo RCM features of PCA lesions from a patient with diabetes and correlate them with histologic findings. This strengthens the clinical usefulness of in vivo RCM examination for the non-invasive diagnosis of cutaneous amyloidosis, especially in patients that might associate diseases with impaired wound healing.
Collapse
Affiliation(s)
- Ana-Maria Ionescu
- First Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Dermatology Research Laboratory, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihaela-Adriana Ilie
- Dermatology Research Laboratory, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Biochemistry, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Virginia Chitu
- First Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Andrei Razvan
- Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Daniela Lixandru
- Department of Biochemistry, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristiana Tanase
- Department of Biochemistry-Proteomics, "Victor Babes" National Institute of Pathology, 050096 Bucharest, Romania
| | - Daniel Boda
- Dermatology Research Laboratory, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, "Prof. N. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Constantin Caruntu
- Department of Dermatology, "Prof. N. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania.
- Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
| | - Sabina Zurac
- Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| |
Collapse
|
17
|
Ilie MA, Caruntu C, Lupu M, Lixandru D, Tampa M, Georgescu SR, Bastian A, Constantin C, Neagu M, Zurac SA, Boda D. Current and future applications of confocal laser scanning microscopy imaging in skin oncology. Oncol Lett 2019; 17:4102-4111. [PMID: 30944603 PMCID: PMC6444326 DOI: 10.3892/ol.2019.10066] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/10/2018] [Indexed: 11/05/2022] Open
Abstract
Confocal laser scanning microscopy (CLSM) is a modern imaging technique that enables the in vivo or ex vivo characterization of skin lesions located in the epidermis and superficial dermis with a high quasi-microscopic resolution. Currently, it is considered to be the most promising imaging tool for the evaluation of superficial skin tumors. The in vivo mode adds the advantage of noninvasive, dynamic, in real-time assessment of the tumor associated vasculature and inflammation. It offers the possibility to repeatedly examine the same skin area without causing any damage and to monitor disease progression and treatment outcome. Furthermore, this novel technology allows the evaluation of the entire lesion and can be used to guide biopsies and to define tumor margins before surgical excision or other invasive therapies. CLSM diagnostic features may differentiate between the various histologic subtypes of skin tumors and therefore helps in choosing the best therapeutic approach. In this study, we present the CLSM characteristic features of the most common melanocytic and non-melanocytic skin tumors, as well as future possible CLSM applications in the study of experimental skin tumorigenesis on animal models.
Collapse
Affiliation(s)
- Mihaela Adriana Ilie
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Biochemistry, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Mihai Lupu
- Department of Dermatology, MEDAS Medical Center, 030442 Bucharest, Romania
| | - Daniela Lixandru
- Department of Biochemistry, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mircea Tampa
- Department of Dermatology, ‘Victor Babes’ Hospital, ‘Carol Davila’ University of Medicine and Pharmacy, 030303 Bucharest, Romania
| | - Simona-Roxana Georgescu
- Department of Dermatology, ‘Victor Babes’ Hospital, ‘Carol Davila’ University of Medicine and Pharmacy, 030303 Bucharest, Romania
| | - Alexandra Bastian
- Department of Pathology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Carolina Constantin
- Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Department of Immunology, ‘Victor Babes’ National Institute of Pathology, 050096 Bucharest, Romania
| | - Monica Neagu
- Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Department of Immunology, ‘Victor Babes’ National Institute of Pathology, 050096 Bucharest, Romania
- Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Sabina Andrada Zurac
- Department of Pathology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Daniel Boda
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| |
Collapse
|
18
|
Levine A, Markowitz O. Introduction to reflectance confocal microscopy and its use in clinical practice. JAAD Case Rep 2018; 4:1014-1023. [PMID: 30456275 PMCID: PMC6232695 DOI: 10.1016/j.jdcr.2018.09.019] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Reflectance confocal microscopy (RCM) is a novel technology that provides noninvasive, in vivo imaging of the skin at nearly histologic resolution. In 2016, the US Centers for Medicare and Medicaid Services (CMS) established reimbursement codes for RCM image acquisition and for the reading and interpretation of images. The combination of RCM imaging with dermoscopy has improved the accuracy of skin cancer diagnosis while reducing the number of biopsies of benign skin lesions. With that, we are starting to see more dermatologists and dermatopathologists using RCM in clinical practice. This editorial is to serve as an introduction on RCM imaging with a focus on its usefulness in both the diagnosis and management of skin cancers. We end by briefly describing the characteristic RCM features of normal skin to serve as a building block for later cases that will explore both the benefits and drawbacks of incorporating RCM imaging for benign and malignant lesions.
Collapse
Affiliation(s)
| | - Orit Markowitz
- Correspondence to: Orit Markowitz, MD, FAAD, 5 East 98th Street, 5th floor, New York, NY 10029.
| |
Collapse
|
19
|
Shahriari N, Grant-Kels JM, Rabinovitz H, Oliviero M, Scope A. In vivo reflectance confocal microscopy image interpretation for the dermatopathologist. J Cutan Pathol 2018; 45:187-197. [DOI: 10.1111/cup.13084] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 11/16/2017] [Accepted: 11/21/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Neda Shahriari
- Department of Dermatology; University of Connecticut Health Center; Farmington Connecticut
| | - Jane M. Grant-Kels
- Department of Dermatology; University of Connecticut Health Center; Farmington Connecticut
| | - Harold Rabinovitz
- Department of Dermatology; University of Miami Miller School of Medicine; Miami Florida
| | - Margaret Oliviero
- Department of Dermatology; University of Miami Miller School of Medicine; Miami Florida
| | - Alon Scope
- Department of Dermatology, Sheba Medical Center and Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| |
Collapse
|
20
|
Guilera JM, Barreiro Capurro A, Carrera Alvárez C, Puig Sardá S. The Role of Reflectance Confocal Microscopy in Clinical Trials for Tumor Monitoring. Dermatol Clin 2017; 34:519-526. [PMID: 27692458 DOI: 10.1016/j.det.2016.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Reflectance confocal microscopy (RCM) allows the evaluation with superb accuracy of some skin tumors before, during, and after treatment. In clinical trials RCM has been shown to provide useful information for evaluation of efficacy of topical or systemic medication. With the recent introduction of handheld RCM a fast examination of the tumor can be done in minutes. In patients treated with surgery RCM plays a unique role to precisely map margins of the tumor in the skin surface and for the detection of subclinical recurrences. This article reviews the use of RCM in the research of different skin cancer tumor treatments.
Collapse
Affiliation(s)
- Josep Malvehy Guilera
- Melanoma Unit, Department of Dermatology Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Carrer Villarroel 170, Barcelona 08036, Spain; Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona 08036, Spain.
| | - Alicia Barreiro Capurro
- Melanoma Unit, Department of Dermatology Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Carrer Villarroel 170, Barcelona 08036, Spain; Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona 08036, Spain
| | - Cristina Carrera Alvárez
- Melanoma Unit, Department of Dermatology Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Carrer Villarroel 170, Barcelona 08036, Spain; Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona 08036, Spain
| | - Susana Puig Sardá
- Melanoma Unit, Department of Dermatology Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Carrer Villarroel 170, Barcelona 08036, Spain; Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona 08036, Spain
| |
Collapse
|
21
|
Rodijk FMW, Zanelli G, Geerligs M, van Erp PEJ, Peppelman M. The influence of different shavers on the skin quantified by non-invasive reflectance confocal microscopy. Skin Res Technol 2016; 22:311-7. [PMID: 27381679 DOI: 10.1111/srt.12263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND The impact of personal care devices on skin is mainly assessed using subjective tools. However, new objective, accurate non-invasive in vivo imaging techniques have been developed. The aim of this study was to evaluate the ability of reflectance confocal microscopy (RCM) in quantifying morphological impact of shavers on skin. Furthermore, tape stripping (TS) as method to study morphological impact of shavers was evaluated. METHODS In 12 healthy male subjects, for two consecutive days, a split-face test was performed in the neck; on one side a shaver was applied, while the other side was exposed to TS. The stratum corneum (SC) thickness was quantified using RCM and sensory observations were evaluated using questionnaires. RESULTS Shavers with a different impact on skin, can be discriminated by RCM; shaver B removed more SC after application than the skin friendlier shaver A. Furthermore, the changes in SC thickness induced by TS corresponded well to that of the shavers. CONCLUSION RCM is able to quantify the impact of different shavers on skin. Besides, TS appeared to be a suitable model mimicking the mechanical impact of shavers on skin. RCM in combination with the TS model appeared to be a suitable minimally invasive model to obtain morphological and cell biological data on skin-material interactions caused by different personal care devices.
Collapse
Affiliation(s)
- F M W Rodijk
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands
| | - G Zanelli
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands
| | - M Geerligs
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands
| | - P E J van Erp
- Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M Peppelman
- Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands
| |
Collapse
|
22
|
Baran U, Choi WJ, Wang RK. Potential use of OCT-based microangiography in clinical dermatology. Skin Res Technol 2016; 22:238-246. [PMID: 26335451 PMCID: PMC4777681 DOI: 10.1111/srt.12255] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Optical coherence tomography (OCT) is a revolutionary imaging technique used commonly in ophthalmology, and on the way to become clinically viable alternative in dermatology due to its capability of acquiring histopathology level details of in vivo tissue, non-invasively. In this study, we demonstrate the capabilities of OCT-based microangiography in detecting high resolution, three-dimensional structural, and microvascular features of in vivo human skin with various conditions. METHODS A swept-source OCT system that operates on a central wavelength of 1310 nm with an A-line rate of 100 kHz is used in this study. We apply optical microangiography (OMAG) technique to visualize the structural and microvascular changes in tissue. RESULTS OMAG images provide detailed visualization of functional microvasculature of healthy human skin from cheek and forehead areas, abnormal skin conditions from face, chest and belly. Moreover, OMAG is capable of monitoring the progress of wound healing on human skin from arm, delivering unprecedented detail of microstructural and microvascular information during longitudinal wound healing process. CONCLUSION The presented results promise the clinical use of OCT angiography, aiming to treat prevalent cutaneous diseases, by detecting blood perfusion, and structural changes within human skin, in vivo.
Collapse
Affiliation(s)
- Utku Baran
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- Department of Electrical Engineering, University of Washington, Seattle, WA, USA
| | - Woo June Choi
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| |
Collapse
|
23
|
Ghita MA, Caruntu C, Rosca AE, Kaleshi H, Caruntu A, Moraru L, Docea AO, Zurac S, Boda D, Neagu M, Spandidos DA, Tsatsakis AM. Reflectance confocal microscopy and dermoscopy for in vivo, non-invasive skin imaging of superficial basal cell carcinoma. Oncol Lett 2016; 11:3019-3024. [PMID: 27123056 PMCID: PMC4840988 DOI: 10.3892/ol.2016.4354] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 03/18/2016] [Indexed: 11/06/2022] Open
Abstract
Superficial basal cell carcinoma (sBCC) is the second most frequent histological type of basal cell carcinoma (BCC), usually requiring a skin biopsy to confirm the diagnosis. It usually appears on the upper trunk and shoulders as erythematous and squamous lesions. Although it has a slow growth and seldom metastasizes, early diagnosis and management are of crucial importance in preventing local invasion and subsequent disfigurement. Dermoscopy is nowadays an indispensable tool for the dermatologist when evaluating skin tumors. Reflectance confocal microscopy (RCM) is a novel imaging technique that allows the non-invasive, in vivo quasi-microscopic morphological and dynamic assessment of superficial skin tumors. Moreover, it offers the advantage of performing infinite repeatable determinations to monitor disease progression and non-surgical treatment for sBCC. Herein, we present three lesions of sBCC evaluated using in vivo and non-invasive imaging techniques, emphasizing the usefulness of combining RCM with dermoscopy for increasing the diagnostic accuracy of sBCC.
Collapse
Affiliation(s)
- Mihaela A Ghita
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 050474, Romania
| | - Constantin Caruntu
- Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 050474, Romania; Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest 011233, Romania
| | - Adrian E Rosca
- Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 050474, Romania; 'Victor Babes' National Institute of Pathology, Bucharest 050096, Romania
| | - Harillaq Kaleshi
- Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest 011233, Romania
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, 'Carol Davila' Central Military Emergency Hospital, Bucharest 010825, Romania
| | - Liliana Moraru
- Department of Oral and Maxillofacial Surgery, 'Carol Davila' Central Military Emergency Hospital, Bucharest 010825, Romania
| | - Anca Oana Docea
- Department of Toxicology, Faculty of Pharmacy, University of Medicine and Pharmacy, Craiova 200349, Romania
| | - Sabina Zurac
- Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, Colentina University Hospital, Bucharest 020125, Romania
| | - Daniel Boda
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 050474, Romania
| | - Monica Neagu
- 'Victor Babes' National Institute of Pathology, Bucharest 050096, Romania
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, University of Crete Medical School, Heraklion 71409, Greece
| | - Aristidis M Tsatsakis
- Department of Forensic Sciences and Toxicology, Medical School, University of Crete, Heraklion 71003, Greece
| |
Collapse
|
24
|
Klemp M, Meinke MC, Weinigel M, Röwert-Huber HJ, König K, Ulrich M, Lademann J, Darvin ME. Comparison of morphologic criteria for actinic keratosis and squamous cell carcinoma using in vivo multiphoton tomography. Exp Dermatol 2016; 25:218-22. [PMID: 26659897 DOI: 10.1111/exd.12912] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2015] [Indexed: 12/25/2022]
Abstract
The routine diagnostic procedure of actinic keratosis (AK) and invasive squamous cell carcinoma (SCC) is a histological examination after taking a biopsy. In the past decades, non-invasive optical methods for skin examination have been developed. Patients with clinical diagnosis of AK or SCC were examined. The morphological criteria were determined for healthy, AK and SCC skin and compared for statistically significant differences. In this study, the applicability of multiphoton tomography (MPT) as an in vivo diagnostic tool for AK and SCC was evaluated. Changes in the morphology of the keratinocytes such as broadened epidermis, large intercellular spaces, enlarged nucleus and a large variance in cell shape could easily be recognized. The cell nuclei of AK and SCC were significantly larger compared to healthy skin cells in all cell layers. The nucleus-cytoplasm ratio was also significantly higher for AK and SCC than for the healthy skin cells. It was even higher in SCC compared to spinous and basal cell layer of AK. The cell density in AK and SCC was significantly lower than in the basal and spinous cell layers of healthy skin. In SCC, the cell density was significantly lower than in AK. Concerning the intercellular spaces, significant differences were found for AK and healthy skin in spinous and basal cell layer and for SCC compared to AK and healthy skin. In this study, MPT proved to be a valuable non-invasive imaging method for in vivo detection and discrimination of AK and SCC from healthy skin.
Collapse
Affiliation(s)
- Marisa Klemp
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martina C Meinke
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Hans-Joachim Röwert-Huber
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Karsten König
- JenLab GmbH, Jena, Germany.,Department of Biophotonics and Laser Technology, Saarland University, Saarbrücken, Germany
| | | | - Juergen Lademann
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Maxim E Darvin
- Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
25
|
Sattler EC, Hoffmann VS, Ruzicka T, Braunmühl TV, Berking C. Reflectance confocal microscopy for monitoring the density of Demodex mites in patients with rosacea before and after treatment. Br J Dermatol 2015; 173:69-75. [PMID: 25801631 DOI: 10.1111/bjd.13783] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Demodex mites seem to serve as a pathogenic trigger in many Demodex-associated diseases such as rosacea. In facial skin of patients with rosacea significantly higher numbers of Demodex mites have been shown compared with healthy controls. Reflectance confocal microscopy (RCM) allows the detection and quantification of Demodex mites in vivo noninvasively. It is hypothesized that a reduction of Demodex mites under rosacea therapy can be monitored by RCM. OBJECTIVES To use RCM to monitor the density of Demodex mites in patients with rosacea before and after treatment. METHODS In 25 patients with facial rosacea RCM was performed before and after therapy. Mosaics of 5 × 5 mm(2) and 8 × 8 mm(2) were scanned, and the total numbers of mites per follicle and per area were counted, along with the number of follicles per area. RESULTS In all patients Demodex folliculorum could be detected and quantified using RCM. RCM showed significant differences pre- and post-treatment (P = 0.0053 for 5 × 5 mm(2) and P < 0.001 for 8 × 8 mm(2)). The mean numbers of mites per follicle were 0.63 (range 0.16-2.28) per 8 × 8 mm(2) area and 0.70 (range 0.11-2.20) per 5 × 5 mm(2) area before treatment, and 0.41 (range 0.074-1.75) and 0.51 (range 0.094-1.70), respectively, after treatment. The corresponding mean numbers of mites were 155 (range 45-446) and 86.2 (range 12-286), respectively, before treatment and 96.2 (range 18-363) and 58.5 (range 12-230), respectively, after treatment. CONCLUSIONS By RCM, a reduction in the density of Demodex mites in facial skin of patients with rosacea under therapy, correlating to clinical improvement, can be quantified and monitored noninvasively. Possible reasons for this therapeutic effect are discussed.
Collapse
Affiliation(s)
- E C Sattler
- Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Frauenlobstraße 9-11, 80337, Munich, Germany
| | - V S Hoffmann
- Institute of Medical Information Sciences, Biometry and Epidemiology (IBE), Ludwig-Maximilian University Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - T Ruzicka
- Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Frauenlobstraße 9-11, 80337, Munich, Germany
| | - T V Braunmühl
- Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Frauenlobstraße 9-11, 80337, Munich, Germany
| | - C Berking
- Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Frauenlobstraße 9-11, 80337, Munich, Germany
| |
Collapse
|
26
|
The use of reflectance confocal microscopy for examination of benign and malignant skin tumors. Postepy Dermatol Alergol 2014; 31:380-7. [PMID: 25610353 PMCID: PMC4293386 DOI: 10.5114/pdia.2014.40961] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 11/19/2013] [Accepted: 12/21/2013] [Indexed: 11/17/2022] Open
Abstract
Reflectance confocal microscopy (RCM) is a modern, non-invasive diagnostic method that enables real-time imaging of epidermis and upper layers of the dermis with a nearly histological precision and high contrast. The application of this technology in skin imaging in the last few years has resulted in the progress of dermatological diagnosis, providing virtual access to the living skin erasing the need for conventional histopathology. The RCM has a potential of wide application in the dermatological diagnostic process with a particular reference to benign and malignant skin tumors. This article provides a summary of the latest reports and previous achievements in the field of RCM application in the diagnostic process of skin neoplasms. A range of dermatological indications and general characteristics of confocal images in various types of tumors are presented.
Collapse
|
27
|
Georges J, Zehri A, Carlson E, Nichols J, Mooney MA, Martirosyan NL, Ghaffari L, Kalani MYS, Eschbacher J, Feuerstein B, Anderson T, Preul MC, Van Keuren-Jensen K, Nakaji P. Label-free microscopic assessment of glioblastoma biopsy specimens prior to biobanking [corrected]. Neurosurg Focus 2014; 36:E8. [PMID: 24484261 DOI: 10.3171/2013.11.focus13478] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Glioblastoma is the most common primary brain tumor with a median 12- to 15-month patient survival. Improving patient survival involves better understanding the biological mechanisms of glioblastoma tumorigenesis and seeking targeted molecular therapies. Central to furthering these advances is the collection and storage of surgical biopsies (biobanking) for research. This paper addresses an imaging modality, confocal reflectance microscopy (CRM), for safely screening glioblastoma biopsy samples prior to biobanking to increase the quality of tissue provided for research and clinical trials. These data indicate that CRM can immediately identify cellularity of tissue biopsies from animal models of glioblastoma. When screening fresh human biopsy samples, CRM can differentiate a cellular glioblastoma biopsy from a necrotic biopsy without altering DNA, RNA, or protein expression of sampled tissue. These data illustrate CRM's potential for rapidly and safely screening clinical biopsy samples prior to biobanking, which demonstrates its potential as an effective screening technique that can improve the quality of tissue biobanked for patients with glioblastoma.
Collapse
|
28
|
Jabbour JM, Bentley JL, Malik BH, Nemechek J, Warda J, Cuenca R, Cheng S, Jo JA, Maitland KC. Reflectance confocal endomicroscope with optical axial scanning for in vivo imaging of the oral mucosa. BIOMEDICAL OPTICS EXPRESS 2014; 5:3781-91. [PMID: 25426310 PMCID: PMC4242017 DOI: 10.1364/boe.5.003781] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 09/22/2014] [Accepted: 09/27/2014] [Indexed: 05/04/2023]
Abstract
This paper presents the design and evaluation of a reflectance confocal laser endomicroscope using a miniature objective lens within a rigid probe in conjunction with an electrically tunable lens for axial scanning. The miniature lens was characterized alone as well as in the endoscope across a 200 µm axial scan range using the tunable lens. The ability of the confocal endoscope to probe the human oral cavity is demonstrated by imaging of the oral mucosa in vivo. The results indicate that reflectance confocal endomicroscopy has the potential to be used in a clinical setting and guide diagnostic evaluation of biological tissue.
Collapse
Affiliation(s)
- Joey M. Jabbour
- Department of Biomedical Engineering, Texas A&M University, 5045 Emerging Technologies Building, 3120 TAMU, College Station, Texas 77843,
USA
| | - Julie L. Bentley
- The Institute of Optics, University of Rochester, 275 Hutchison Road, Rochester, New York 14620,
USA
| | - Bilal H. Malik
- Department of Biomedical Engineering, Texas A&M University, 5045 Emerging Technologies Building, 3120 TAMU, College Station, Texas 77843,
USA
| | - John Nemechek
- Metrology Concepts LLC., 3495 Winton Place, Bldg E-120, Rochester, New York 14623,
USA
| | - John Warda
- Optics Technology Inc., 3800 Monroe Avenue, Suite # 6, Pittsford, New York 14534,
USA
| | - Rodrigo Cuenca
- Department of Biomedical Engineering, Texas A&M University, 5045 Emerging Technologies Building, 3120 TAMU, College Station, Texas 77843,
USA
| | - Shuna Cheng
- Department of Biomedical Engineering, Texas A&M University, 5045 Emerging Technologies Building, 3120 TAMU, College Station, Texas 77843,
USA
| | - Javier A. Jo
- Department of Biomedical Engineering, Texas A&M University, 5045 Emerging Technologies Building, 3120 TAMU, College Station, Texas 77843,
USA
| | - Kristen C. Maitland
- Department of Biomedical Engineering, Texas A&M University, 5045 Emerging Technologies Building, 3120 TAMU, College Station, Texas 77843,
USA
| |
Collapse
|
29
|
Kubanova AA, Chikin VV, Shtirshneider YUYU, Katunina OR. Confocal laser scanning microscopy in vivo for diagnosing melanocytic skin neoplasms. VESTNIK DERMATOLOGII I VENEROLOGII 2014. [DOI: 10.25208/0042-4609-2014-90-3-85-94] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The authors discuss the use of confocal laser scanning microscopy in vivo (CLSM) for diagnosing melanocytic skin neoplasms and its value for early diagnostics of melanoma. CLSM is an innovation noninvasive visual examination method for real-time multiple and painless examinations of the patient’s skin without injuring the skin integument. The method ensures early diagnostics of skin melanomas with high sensitivity and specificity, which makes it possible to use CLSM for screening melanocytic skin neoplasms for the sake of the early onset of treatment to save patient life and health.
Collapse
|
30
|
Confocal Microscopy Patterns in Nonmelanoma Skin Cancer and Clinical Applications. ACTAS DERMO-SIFILIOGRAFICAS 2014. [DOI: 10.1016/j.adengl.2014.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
|
31
|
Zehri AH, Ramey W, Georges JF, Mooney MA, Martirosyan NL, Preul MC, Nakaji P. Neurosurgical confocal endomicroscopy: A review of contrast agents, confocal systems, and future imaging modalities. Surg Neurol Int 2014; 5:60. [PMID: 24872922 PMCID: PMC4033764 DOI: 10.4103/2152-7806.131638] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 02/13/2014] [Indexed: 01/15/2023] Open
Abstract
Background: The clinical application of fluorescent contrast agents (fluorescein, indocyanine green, and aminolevulinic acid) with intraoperative microscopy has led to advances in intraoperative brain tumor imaging. Their properties, mechanism of action, history of use, and safety are analyzed in this report along with a review of current laser scanning confocal endomicroscopy systems. Additional imaging modalities with potential neurosurgical utility are also analyzed. Methods: A comprehensive literature search was performed utilizing PubMed and key words: In vivo confocal microscopy, confocal endomicroscopy, fluorescence imaging, in vivo diagnostics/neoplasm, in vivo molecular imaging, and optical imaging. Articles were reviewed that discussed clinically available fluorophores in neurosurgery, confocal endomicroscopy instrumentation, confocal microscopy systems, and intraoperative cancer diagnostics. Results: Current clinically available fluorescent contrast agents have specific properties that provide microscopic delineation of tumors when imaged with laser scanning confocal endomicroscopes. Other imaging modalities such as coherent anti-Stokes Raman scattering (CARS) microscopy, confocal reflectance microscopy, fluorescent lifetime imaging (FLIM), two-photon microscopy, and second harmonic generation may also have potential in neurosurgical applications. Conclusion: In addition to guiding tumor resection, intraoperative fluorescence and microscopy have the potential to facilitate tumor identification and complement frozen section analysis during surgery by providing real-time histological assessment. Further research, including clinical trials, is necessary to test the efficacy of fluorescent contrast agents and optical imaging instrumentation in order to establish their role in neurosurgery.
Collapse
Affiliation(s)
- Aqib H Zehri
- Neurosurgery Research Laboratory, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Wyatt Ramey
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Joseph F Georges
- Neurosurgery Research Laboratory, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA ; School of Life Sciences, Arizona State University, Tempe, Arizona, USA
| | - Michael A Mooney
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Nikolay L Martirosyan
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA ; Division of Neurosurgery, Department of Surgery, The University of Arizona, Tucson, AZ, Arizona, USA
| | - Mark C Preul
- Neurosurgery Research Laboratory, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Peter Nakaji
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| |
Collapse
|
32
|
Başaran YK, Gürel MS, Erdemir AT, Turan E, Yurt N, Bağci IS. Evaluation of the response to treatment of psoriasis vulgaris with reflectance confocal microscopy. Skin Res Technol 2014; 21:18-24. [DOI: 10.1111/srt.12150] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Y. K. Başaran
- Sanliurfa Training and Research Hospital; Dermatology Clinic; Sanliurfa; Turkey
| | - M. S. Gürel
- Istanbul Training and Research Hospital; Dermatology Department; Istanbul Turkey
| | - A. T. Erdemir
- Istanbul Training and Research Hospital; Dermatology Department; Istanbul Turkey
| | - E. Turan
- Harran University School of Medicine; Dermatology Department; Sanliurfa Turkey
| | - N. Yurt
- Gumushane State Hospital; Dermatology Clinic; Gumushane Turkey
| | - I. S. Bağci
- Istanbul Training and Research Hospital; Dermatology Department; Istanbul Turkey
| |
Collapse
|
33
|
Turgut Erdemir A, Gurel MS, Koku Aksu AE, Bilgin Karahalli F, Incel P, Kutlu Haytoğlu NS, Falay T. Reflectance confocal microscopy vs. standardized skin surface biopsy for measuring the density of Demodex mites. Skin Res Technol 2014; 20:435-9. [PMID: 24521295 DOI: 10.1111/srt.12137] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reflectance confocal microscopy (RCM) has been recently shown to be effective for measuring the Demodex mite density. OBJECTIVES To compare and demonstrate the advantages and disadvantages of standardized skin surface biopsy (SSSB) and RCM for measuring the density of Demodex mites. MATERIALS AND METHODS Forty-eight patients (30 female, 18 male) and 47 healthy controls (30 female, 17 male) were enrolled in the study. The patients diagnoses were pityriasis folliculorum (n = 40), papulopustulary rosecea (n = 7) and erythema-telengiectatic rosacea (n = 1). The area with the most intense erythema on the right cheek was selected for imaging with RCM (VivaScope 3000) and SSSB. RESULTS Forty-two patients demonstrated high Demodex density [(Dd) > 5 mites/cm(2) ] with SSSB (85.7%). RCM identified demodicosis in 48 patients (100%). The mean Dd measured with RCM (409.8 ± 209.2) was significantly higher than SSSB (15.33 ± 18.1) (P < 0.001). In the patients, RCM demonstrated the mean number of mites 40.90 ± 20.9 and 4.11 ± 6.4 in the controls per 10 mm(2) area. The corresponding mean number of 2.63 ± 0.77 mites was detected in the infested follicles per area of view compared to a mean of 0.77 ± 0.98 mites in the infested follicles in the controls (P < 0.001). CONCLUSION Reflectance confocal microscopy is a fast, direct and noninvasive method for Demodex-associated diseases and it is superior to SSSB for Demodex mite detection.
Collapse
Affiliation(s)
- A Turgut Erdemir
- Dermatology Department, Istanbul Training and Research Hospital, Istanbul, Turkey
| | | | | | | | | | | | | |
Collapse
|
34
|
Sattler ECE, Poloczek K, Kästle R, Welzel J. Confocal laser scanning microscopy and optical coherence tomography for the evaluation of the kinetics and quantification of wound healing after fractional laser therapy. J Am Acad Dermatol 2013; 69:e165-73. [DOI: 10.1016/j.jaad.2013.04.052] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 04/19/2013] [Accepted: 04/26/2013] [Indexed: 11/24/2022]
|
35
|
Varghese B, Verhagen R, Hussain A, Boudot C, Tai Q, Ding S, Holz JA, Uzunbajakava NE. Quantitative assessment of birefringent skin structures in scattered light confocal imaging using radially polarized light. SENSORS 2013; 13:12527-35. [PMID: 24048342 PMCID: PMC3821312 DOI: 10.3390/s130912527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 08/14/2013] [Accepted: 09/11/2013] [Indexed: 11/16/2022]
Abstract
The polarization characteristics of birefringent tissues could be only partially obtained using linearly polarized light in polarization sensitive optical imaging. Here we analyze the change in polarization of backscattered light from birefringent structures versus the orientations of the incident polarizations using linearly, circularly and radially polarized light in a cross-polarized confocal microscope. A spatially variable retardation plate composed of eight sectors of λ/2 wave plates was used to transform linearly polarized light into a radially polarized light. Based on the experimental data obtained from ex-vivo measurements on human scalp hairs and in-vivo measurements on hair and skin, we exemplify that the underestimation of the birefringence content resulting from the orientation related effects associated with the use of linearly polarized light for imaging tissues containing wavy birefringent structures could be minimized by using radially polarized light.
Collapse
Affiliation(s)
- Babu Varghese
- Care & Health Applications Group, Philips Research Europe, High Tech Campus 34, 5656AE Eindhoven, The Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|
36
|
González S, Sánchez V, González-Rodríguez A, Parrado C, Ullrich M. Confocal microscopy patterns in nonmelanoma skin cancer and clinical applications. ACTAS DERMO-SIFILIOGRAFICAS 2013; 105:446-58. [PMID: 24002008 DOI: 10.1016/j.ad.2013.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 02/26/2013] [Accepted: 03/18/2013] [Indexed: 01/07/2023] Open
Abstract
Reflectance confocal microscopy is currently the most promising noninvasive diagnostic tool for studying cutaneous structures between the stratum corneum and the superficial reticular dermis. This tool gives real-time images parallel to the skin surface; the microscopic resolution is similar to that of conventional histology. Numerous studies have identified the main confocal features of various inflammatory skin diseases and tumors, demonstrating the good correlation of these features with certain dermatoscopic patterns and histologic findings. Confocal patterns and diagnostic algorithms have been shown to have high sensitivity and specificity in melanoma and nonmelanoma skin cancer. Possible present and future applications of this noninvasive technology are wide ranging and reach beyond its use in noninvasive diagnosis. This tool can also be used, for example, to evaluate dynamic skin processes that occur after UV exposure or to assess tumor response to noninvasive treatments such as photodynamic therapy. We explain the characteristic confocal features found in the main nonmelanoma skin tumors and discuss possible applications for this novel diagnostic technique in routine dermatology practice.
Collapse
Affiliation(s)
- S González
- Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, EE. UU.; Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, España.
| | - V Sánchez
- Servicio de Dermatología, Hospital Universitario Madrid Sanchinarro, Universidad CEU San Pablo, Madrid, España
| | | | - C Parrado
- Departamento de Histología y Anatomía Patológica, Universidad de Málaga, Málaga, España
| | - M Ullrich
- Skin Cancer Center Charité, Department of Dermatology, Charité University Medicine, Berlín, Alemania
| |
Collapse
|
37
|
Sattler EC, Maier T, Hoffmann VS, Hegyi J, Ruzicka T, Berking C. Noninvasive in vivo detection and quantification of Demodex mites by confocal laser scanning microscopy. Br J Dermatol 2013; 167:1042-7. [PMID: 22716072 DOI: 10.1111/j.1365-2133.2012.11096.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In many Demodex-associated skin diseases Demodex mites are present in abundance and seem to be at least partially pathogenic. So far all diagnostic approaches such as scraping or standardized superficial skin biopsy are (semi-)invasive and may cause discomfort to the patient. OBJECTIVES To see whether confocal laser scanning microscopy (CLSM) - a noninvasive method for the visualization of superficial skin layers - is able to detect and quantify D. folliculorum in facial skin of patients with rosacea. METHODS Twenty-five patients (34-72 years of age) with facial rosacea and 25 age- and sex-matched normal controls were examined by CLSM. Mosaics of 8 × 8 mm and 5 × 5 mm were created by scanning horizontal layers of lesional skin and quantification of mites per follicle and per area as well as follicles per area was performed. RESULTS In all patients D. folliculorum could be detected by CLSM and presented as roundish or lengthy cone-shaped structures. CLSM allowed the quantification of Demodex mites and revealed significant differences (P < 0·0001): the mean number of mites was 165·4 per 8 × 8 mm area and 94·2 per 5 × 5 mm area in the patients compared with 34·7 and 22·4, respectively, in the controls. The corresponding mean number of mites per follicle was 0·7 and 0·8, respectively, in the patients and 0·1 and 0·2, respectively, in the controls. CONCLUSIONS With the help of CLSM it is possible to detect, image and quantify Demodex mites noninvasively in facial skin of patients with rosacea.
Collapse
Affiliation(s)
- E C Sattler
- Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Frauenlobstr. 9-11, 80337 Munich, Germany.
| | | | | | | | | | | |
Collapse
|
38
|
Wheller L, Lin LL, Chai E, Sinnya S, Soyer HP, Prow TW. Noninvasive methods for the assessment of photoageing. Australas J Dermatol 2013; 54:290-5. [DOI: 10.1111/ajd.12030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 12/09/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Laura Wheller
- Dermatology Research Centre; The University of Queensland; School of Medicine; Princess Alexandra Hospital; Brisbane Queensland Australia
| | - Lynlee L Lin
- Dermatology Research Centre; The University of Queensland; School of Medicine; Princess Alexandra Hospital; Brisbane Queensland Australia
| | - Eric Chai
- Dermatology Research Centre; The University of Queensland; School of Medicine; Princess Alexandra Hospital; Brisbane Queensland Australia
| | - Sudipta Sinnya
- Dermatology Research Centre; The University of Queensland; School of Medicine; Princess Alexandra Hospital; Brisbane Queensland Australia
| | - H Peter Soyer
- Dermatology Research Centre; The University of Queensland; School of Medicine; Princess Alexandra Hospital; Brisbane Queensland Australia
| | - Tarl W Prow
- Dermatology Research Centre; The University of Queensland; School of Medicine; Princess Alexandra Hospital; Brisbane Queensland Australia
| |
Collapse
|
39
|
Laser skin rejuvenation: epidermal changes and collagen remodeling evaluated by in vivo confocal microscopy. Lasers Med Sci 2012; 28:769-76. [DOI: 10.1007/s10103-012-1145-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 06/21/2012] [Indexed: 10/28/2022]
|
40
|
Longo C, Casari A, De Pace B, Simonazzi S, Mazzaglia G, Pellacani G. Proposal for anin vivohistopathologic scoring system for skin aging by means of confocal microscopy. Skin Res Technol 2012; 19:e167-73. [DOI: 10.1111/j.1600-0846.2012.00623.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Caterina Longo
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; Reggio Emilia; Italy
| | - Alice Casari
- Department of Dermatology; University of Modena and Reggio Emilia; Modena; Italy
| | - Barbara De Pace
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; Reggio Emilia; Italy
| | - Silvia Simonazzi
- Department of Dermatology; University of Modena and Reggio Emilia; Modena; Italy
| | - Giovanna Mazzaglia
- Department of Dermatology; University of Modena and Reggio Emilia; Modena; Italy
| | | |
Collapse
|
41
|
Sattler E, Kästle R, Arens-Corell M, Welzel J. How long does protection last? - In vivo fluorescence confocal laser scanning imaging for the evaluation of the kinetics of a topically applied lotion in an everyday setting. Skin Res Technol 2011; 18:370-7. [DOI: 10.1111/j.1600-0846.2011.00579.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2011] [Indexed: 11/29/2022]
Affiliation(s)
- E. Sattler
- Department of Dermatology and Allergology; Ludwig-Maximilians-University of Munich; Munich; Germany
| | - R. Kästle
- Department of Dermatology and Allergology; General Hospital Augsburg; Augsburg; Germany
| | | | - J. Welzel
- Department of Dermatology and Allergology; General Hospital Augsburg; Augsburg; Germany
| |
Collapse
|
42
|
Varghese B, Verhagen R, Tai Q, Hussain A, Boudot C, Uzunbajakava N. Contrast improvement in scattered light confocal imaging of skin birefringent structures by depolarization detection. JOURNAL OF BIOPHOTONICS 2011; 4:850-858. [PMID: 22012914 DOI: 10.1002/jbio.201100063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 10/03/2011] [Accepted: 10/04/2011] [Indexed: 05/31/2023]
Abstract
Here we describe a method for enhancing the contrast in imaging skin birefringent structures. The method relies on polarization-dependent optical properties and is implemented using cross polarized confocal microscopy. The experimental data obtained using ex-vivo and in-vivo measurements on human scalp hairs and human skin demonstrate a significant dependence of the change in polarization of light that interacted with the birefringent hair on the orientation of the incident polarization. The polarization dependent contrast, defined as the ratio of intensity measured for different orientations of the incident polarization when observed using cross polarized confocal microscopy furthermore depends on the hair type/degree of pigmentation and on the focusing depth inside the hair. No such dependence was observed for the upper skin layers, including the stratum corneum and epidermis. We propose a new method for enhancing the contrast between the skin and the birefringent hair by the use of cross polarized confocal microscopy combined with the variation of the polarization of the incoming light. Potential applications of this method include imaging of hairs for assessing the efficacy of hair removal methods and measurement of skin birefringence. The underestimation of the birefringence content resulting from the orientation related effects associated with the use of linearly polarized light for imaging tissues containing wavy birefringent structures could be minimized by this method.
Collapse
Affiliation(s)
- Babu Varghese
- Care and Health Applications Group, Philips Research Europe, High Tech Campus 34, 5656 AE Eindhoven, The Netherlands.
| | | | | | | | | | | |
Collapse
|
43
|
Guitera P, Menzies SW. State of the art of diagnostic technology for early-stage melanoma. Expert Rev Anticancer Ther 2011; 11:715-23. [PMID: 21554047 DOI: 10.1586/era.11.43] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the past few decades, rapid improvements in noninvasive optical technologies have revolutionized the diagnosis of early-stage melanoma. Current knowledge and limitations of these tools will be reviewed in this article. Dermoscopy has been recognized as the 'gold standard' in the screening phase. Digital dermoscopy monitoring and total-body photography are used to identify so-called 'featureless' melanoma only on the criteria of change over time. Automated instruments, as well as optical and nonmorphological methods, are still under development, and offer many opportunities to improve the speed and accuracy of the diagnosis of melanoma and/or to reduce the need for expertise. Despite a penetration depth limited to the upper dermis, the quasi-histological imaging achieved by in vivo reflectance confocal microscopy has been demonstrated to significantly aid diagnostic accuracy for selected melanocytic lesions. Future perspectives on diagnostic instrumentation will also be explored.
Collapse
|
44
|
Webber SA, Wurm EMT, Douglas NC, Lambie D, Longo C, Pellacani G, Soyer HP. Effectiveness and limitations of reflectance confocal microscopy in detecting persistence of basal cell carcinomas: a preliminary study. Australas J Dermatol 2011; 52:179-85. [PMID: 21834812 DOI: 10.1111/j.1440-0960.2011.00769.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVES Reflectance confocal microscopy (RCM) can accurately and non-invasively diagnose basal cell carcinoma (BCC). The use of RCM in assessing responses to saucerization or curettage and cautery of BCC has not been established. The aim of the present study was to expound the usefulness of RCM in assessing treatment responses of BCC to saucerization or curettage and cautery 8-12 weeks after treatment. METHODS Eight sequential patients, with 11 superficial BCCs, were recruited. Lesions were evaluated clinically and dermoscopically. Three operators performed RCM imaging for each BCC at baseline and 8-12 weeks after treatment. Diagnostic criteria for RCM diagnosis included streaming of basal cells and the presence of cord-like structures and horizontal vessels. Results were compared against histopathology. Difficulties in establishing tumour clearance were identified and the effectiveness of RCM in assessing the response to treatment was explored. RESULTS At baseline, all lesions were consistent with superficial BCC. At 8-12 weeks after treatment, RCM correctly diagnosed 10 of 11 lesions as tumour free. Furthermore, RCM was reliable across operators of variable experience and the findings were confirmed histopathologically. Limitations were identified, but appeared to be related to operator experience. CONCLUSION The diagnosis of BCC was straightforward and reliable in the present study. Thus, RCM appears useful in assessing the early treatment response of superficial BCC treated with saucerization or curettage and cautery despite operator-dependent limitations.
Collapse
Affiliation(s)
- Scott A Webber
- Department of Dermatology, The University of Queensland, School of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
| | | | | | | | | | | | | |
Collapse
|
45
|
Fan C, Luedtke MA, Prouty SM, Burrows M, Kollias N, Cotsarelis G. Characterization and quantification of wound-induced hair follicle neogenesis using in vivo confocal scanning laser microscopy. Skin Res Technol 2011; 17:387-97. [PMID: 21492240 DOI: 10.1111/j.1600-0846.2011.00508.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND In vivo confocal scanning laser microscopy (CSLM) is a recently developed non-invasive technique for visualizing microscopic structures with the skin. CSLM has been used to characterize proliferative and inflammatory skin diseases, neoplastic skin lesions and pigmented lesions. OBJECTIVE Here, we assessed the ability of CSLM to evaluate the formation of neogenic hair follicles after a full-thickness wound in mice. METHODS Full-thickness wounds were made on the dorsal skin of 3-week-old mice. After scab detachment (SD), the number, width, length, space and volume of neogenic hair follicles were analyzed using CSLM. The results were compared with those from conventional methods, including staining for alkaline phosphatase (AP) and keratin 17 (K17) as well as histology. RESULTS Quantification of neogenic hair follicles using CSLM compared favorably with the results from direct measurements on isolated epidermal tissue after immunostaining for K17, a marker for the epithelial portion of new hair follicles. CSLM detected 89% of K17-stained follicles. CSLM more accurately quantified the number of new follicles compared with AP staining, which detects the dermal portion of the new follicle. The width and length measurement from CSLM and histology were very close and correlated with each other. The minimum length of a neogenic hair follicle that could be detected by CSLM was 21 μm. The space between neogenic hair follicles was decreased in histological sections compared with CSLM. CONCLUSION CSLM is an accurate and valuable method for counting and measuring neogenic hair follicles non-invasively. CSLM produces images similar to histology in mice. Measurements of microstructures using CSLM more accurately reflect actual sizes as this technique avoids fixation artifacts. In vivo visualization of developing follicles with CSLM allows the detection of serial changes in hair follicle formation, thus conserving the numbers of mice required for studies and improving the detection of temporal changes in developing hair follicles.
Collapse
Affiliation(s)
- Chengxiang Fan
- School of Biomedical Engineering, Science & Health Systems, Drexel University, Philadelphia, PA, USA
| | | | | | | | | | | |
Collapse
|
46
|
Treu CM, Lupi O, Bottino DA, Bouskela E. Sidestream dark field imaging: the evolution of real-time visualization of cutaneous microcirculation and its potential application in dermatology. Arch Dermatol Res 2010; 303:69-78. [DOI: 10.1007/s00403-010-1087-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 09/22/2010] [Accepted: 09/24/2010] [Indexed: 02/04/2023]
|
47
|
Manela-Azulay M, Cuzzi T, Pinheiro JCA, Azulay DR, Rangel GB. [Objective methods for analyzing outcomes in research studies on cosmetic dermatology]. An Bras Dermatol 2010; 85:65-71. [PMID: 20464089 DOI: 10.1590/s0365-05962010000100009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Accepted: 11/04/2009] [Indexed: 11/21/2022] Open
Abstract
Cosmetic dermatology is a field of medicine that is in constant development; therefore, the use of objective methods for validating the findings of scientific studies is crucial. The most commonly used techniques in the majority of these studies include histopathology, immunohistochemistry, morphometry, stereology, digital photography, biometry, optical profilometry and confocal microscopy. The objective of this review was to provide an update on the principal methods used as tools for analyzing outcomes and also to provide the dermatologist with means of sharpening his/her critical judgement with respect to the publications and presentations that use subjective evaluation methods.
Collapse
|
48
|
Rito C, Pineiro-Maceira J. [Reflectance confocal microscopy in the diagnosis of cutaneous melanoma]. An Bras Dermatol 2010; 84:636-42. [PMID: 20191175 DOI: 10.1590/s0365-05962009000600009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 09/21/2009] [Indexed: 11/21/2022] Open
Abstract
Skin melanoma is an international public health issue, with a considerable increase in frequency over the past few years. Early diagnosis and excision are essential for good patient prognosis. Over the past two decades dermoscopy has gained significance due to a major improvement in the accuracy of skin melanoma diagnosis in its early stage. However, there are some benign lesions of questionable dermoscopy, which may lead to the performance of unnecessary surgery. Recently, reflectance confocal microscopy has been introduced as a promising supplementary diagnostic method. It is a noninvasive, in vivo, simple, painless and quick exam. It is the only technique capable of identifying cellular structures and to examine the epidermis and papillary dermis with a resolution similar to that of histopathology, with a sensitivity of 97.3% and specificity of 72.3 % in the diagnosis of cutaneous melanoma. This is an important diagnostic tool, because it does not substitute post-surgical histopathological examination and allows for the rational assessment of lesions of questionable dermoscopy, thus avoiding unnecessary surgical procedures.
Collapse
Affiliation(s)
- Cintia Rito
- Universidade Federal do Rio de Janeiro, Brazil.
| | | |
Collapse
|
49
|
Stamatas GN, Nikolovski J, Luedtke MA, Kollias N, Wiegand BC. Infant skin microstructure assessed in vivo differs from adult skin in organization and at the cellular level. Pediatr Dermatol 2010; 27:125-31. [PMID: 19804498 DOI: 10.1111/j.1525-1470.2009.00973.x] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Functional differences between infant and adult skin may be attributed to putative differences in skin microstructure. The purpose of this study was to examine infant skin microstructure in vivo and to compare it with that of adult skin. The lower thigh area of 20 healthy mothers (ages 25-43) and their biological children (ages 3-24 months) was examined using in vivo noninvasive methods including fluorescence spectroscopy, video microscopy, and confocal laser scanning microscopy. Stratum corneum and supra-papillary epidermal thickness as well as cell size in the granular layer were assessed from the confocal images. Adhesive tapes were used to remove corneocytes from the outer-most layer of stratum corneum and their size was computed using image analysis. Surface features showed differences in glyph density and surface area. Infant stratum corneum was found to be 30% and infant epidermis 20% thinner than in adults. Infant corneocytes were found to be 20% and granular cells 10% smaller than adult corneocytes indicating a more rapid cell turnover in infants. This observation was confirmed by fluorescence spectroscopy. Dermal papillae density and size distribution also differed. Surprisingly, a distinct direct structural relationship between the stratum corneum morphology and the dermal papillae was observed exclusively in infant skin. A change in reflected signal intensity at approximately 100 mum indicating the transition between papillary and reticular dermis was evident only in adult skin. We demonstrate in vivo qualitative and quantitative differences in morphology between infant and adult skin. These differences in skin microstructure may help explain some of the reported functional differences.
Collapse
Affiliation(s)
- Georgios N Stamatas
- Baby Science & Technology, Johnson & Johnson Consumer France, Issy-les-Moulineaux, France.
| | | | | | | | | |
Collapse
|
50
|
Aguirre AD, Chen Y, Bryan B, Mashimo H, Huang Q, Connolly JL, Fujimoto JG. Cellular resolution ex vivo imaging of gastrointestinal tissues with optical coherence microscopy. JOURNAL OF BIOMEDICAL OPTICS 2010; 15:016025. [PMID: 20210470 PMCID: PMC2847935 DOI: 10.1117/1.3322704] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Revised: 12/29/2009] [Accepted: 12/31/2009] [Indexed: 05/17/2023]
Abstract
Optical coherence microscopy (OCM) combines confocal microscopy and optical coherence tomography (OCT) to improve imaging depth and contrast, enabling cellular imaging in human tissues. We aim to investigate OCM for ex vivo imaging of upper and lower gastrointestinal tract tissues, to establish correlations between OCM imaging and histology, and to provide a baseline for future endoscopic studies. Co-registered OCM and OCT imaging were performed on fresh surgical specimens and endoscopic biopsy specimens, and images were correlated with histology. Imaging was performed at 1.06-microm wavelength with <2-microm transverse and <4-microm axial resolution for OCM, and at 14-microm transverse and <3-microm axial resolution for OCT. Multiple sites on 75 tissue samples from 39 patients were imaged. OCM enabled cellular imaging of specimens from the upper and lower gastrointestinal tracts over a smaller field of view compared to OCT. Squamous cells and their nuclei, goblet cells in Barrett's esophagus, gastric pits and colonic crypts, and fine structures in adenocarcinomas were visualized. OCT provided complementary information through assessment of tissue architectural features over a larger field of view. OCM may provide a complementary imaging modality to standard OCT approaches for endoscopic microscopy.
Collapse
Affiliation(s)
- Aaron D Aguirre
- Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, Cambridge, Massachusetts 02139, USA
| | | | | | | | | | | | | |
Collapse
|