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Bhardwaj V, Handler MZ, Mao J, Azadegan C, Panda PK, Breunig HG, Wenskus I, Diaz I, König K. A novel professional-use synergistic peel technology to reduce visible hyperpigmentation on face: Clinical evidence and mechanistic understanding by computational biology and optical biopsy. Exp Dermatol 2024; 33:e15069. [PMID: 38568090 DOI: 10.1111/exd.15069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 02/03/2024] [Accepted: 03/14/2024] [Indexed: 04/05/2024]
Abstract
Topicals and chemical peels are the standard of care for management of facial hyperpigmentation. However, traditional therapies have come under recent scrutiny, such as topical hydroquinone (HQ) has some regulatory restrictions, and high concentration trichloroacetic acid (TCA) peel pose a risk in patients with skin of colour. The objective of our research was to identify, investigate and elucidate the mechanism of action of a novel TCA- and HQ-free professional-use chemical peel to manage common types of facial hyperpigmentation. Using computational modelling and in vitro assays on tyrosinase, we identified proprietary multi-acid synergistic technology (MAST). After a single application on human skin explants, MAST peel was found to be more effective than a commercial HQ peel in inhibiting melanin (histochemical imaging and gene expression). All participants completed the case study (N = 9) without any adverse events. After administration of the MAST peel by a dermatologist, the scoring and VISIA photography reported improvements in hyperpigmentation, texture and erythema, which could be linked to underlying pathophysiological changes in skin after peeling, visualized by non-invasive optical biopsy of face. Using reflectance confocal microscopy (VivaScope®) and multiphoton tomography (MPTflex™), we observed reduction in melanin, increase in metabolic activity of keratinocytes, and no signs of inflammatory cells after peeling. Subsequent swabbing of the cheek skin found no microbiota dysbiosis resulting from the chemical peel. The strong efficacy with minimum downtime and no adverse events could be linked to the synergistic action of the ingredients in the novel HQ- and TCA-free professional peel technology.
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Affiliation(s)
- Vinay Bhardwaj
- Department of Global Personal Care and Skin Health R&D, Colgate-Palmolive Company, Piscataway, New Jersey, USA
| | - Marc Zachary Handler
- Dermal Clinical Research, Colgate-Palmolive Company, Piscataway, New Jersey, USA
| | - Junhong Mao
- Department of Global Personal Care and Skin Health R&D, Colgate-Palmolive Company, Piscataway, New Jersey, USA
| | - Chloe Azadegan
- Department of Global Personal Care and Skin Health R&D, Colgate-Palmolive Company, Piscataway, New Jersey, USA
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Pritam K Panda
- Department of Physics and Astronomy, Uppsala University, Uppsala, Sweden
- Nerdalytics, Uppsala, Sweden
| | | | | | - Isabel Diaz
- Dermal Clinical Research, Colgate-Palmolive Company, Piscataway, New Jersey, USA
| | - Karsten König
- JenLab GmbH, Berlin, Germany
- Department of Biophotonics and Laser Technology, Saarland University, Saarbrucken, Germany
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Shiu J, Lentsch G, Polleys CM, Mobasher P, Ericson M, Georgakoudi I, Ganesan AK, Balu M. Noninvasive Imaging Techniques for Monitoring Cellular Response to Treatment in Stable Vitiligo. J Invest Dermatol 2024; 144:912-915.e2. [PMID: 37952609 PMCID: PMC11081004 DOI: 10.1016/j.jid.2023.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/27/2023] [Accepted: 10/06/2023] [Indexed: 11/14/2023]
Affiliation(s)
- Jessica Shiu
- Department of Dermatology, University of California, Irvine, Irvine, California, USA.
| | - Griffin Lentsch
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA
| | | | - Pezhman Mobasher
- Department of Dermatology, University of California, Irvine, Irvine, California, USA
| | - Marissa Ericson
- Biostatistics, Epidemiology and Research Design, University of California, Irvine, Irvine, California, USA
| | - Irene Georgakoudi
- Department of Biomedical Engineering, Tufts University, Medford, Massachusetts, USA
| | - Anand K Ganesan
- Department of Dermatology, University of California, Irvine, Irvine, California, USA; Department of Biological Chemistry, University of California, Irvine, Irvine, California, USA; Skin Biology Resource Center, University of California, Irvine, Irvine, California, USA
| | - Mihaela Balu
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA; Skin Biology Resource Center, University of California, Irvine, Irvine, California, USA
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Setchfield K, Gorman A, Simpson AHRW, Somekh MG, Wright AJ. Effect of skin color on optical properties and the implications for medical optical technologies: a review. JOURNAL OF BIOMEDICAL OPTICS 2024; 29:010901. [PMID: 38269083 PMCID: PMC10807857 DOI: 10.1117/1.jbo.29.1.010901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/15/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024]
Abstract
Significance Skin color affects light penetration leading to differences in its absorption and scattering properties. COVID-19 highlighted the importance of understanding of the interaction of light with different skin types, e.g., pulse oximetry (PO) unreliably determined oxygen saturation levels in people from Black and ethnic minority backgrounds. Furthermore, with increased use of other medical wearables using light to provide disease information and photodynamic therapies to treat skin cancers, a thorough understanding of the effect skin color has on light is important for reducing healthcare disparities. Aim The aim of this work is to perform a thorough review on the effect of skin color on optical properties and the implication of variation on optical medical technologies. Approach Published in vivo optical coefficients associated with different skin colors were collated and their effects on optical penetration depth and transport mean free path (TMFP) assessed. Results Variation among reported values is significant. We show that absorption coefficients for dark skin are ∼ 6 % to 74% greater than for light skin in the 400 to 1000 nm spectrum. Beyond 600 nm, the TMFP for light skin is greater than for dark skin. Maximum transmission for all skin types was beyond 940 nm in this spectrum. There are significant losses of light with increasing skin depth; in this spectrum, depending upon Fitzpatrick skin type (FST), on average 14% to 18% of light is lost by a depth of 0.1 mm compared with 90% to 97% of the remaining light being lost by a depth of 1.93 mm. Conclusions Current published data suggest that at wavelengths beyond 940 nm light transmission is greatest for all FSTs. Data beyond 1000 nm are minimal and further study is required. It is possible that the amount of light transmitted through skin for all skin colors will converge with increasing wavelength enabling optical medical technologies to become independent of skin color.
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Affiliation(s)
- Kerry Setchfield
- University of Nottingham, Faculty of Engineering, Optics and Photonics Research Group, Nottingham, United Kingdom
| | - Alistair Gorman
- University of Edinburgh, School of Engineering, Edinburgh, United Kingdom
| | - A. Hamish R. W. Simpson
- University of Edinburgh, Department of Orthopaedics, Division of Clinical and Surgical Sciences, Edinburgh, United Kingdom
| | - Michael G. Somekh
- University of Nottingham, Faculty of Engineering, Optics and Photonics Research Group, Nottingham, United Kingdom
- Zhejiang Lab, Hangzhou, China
| | - Amanda J. Wright
- University of Nottingham, Faculty of Engineering, Optics and Photonics Research Group, Nottingham, United Kingdom
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Mizukoshi K, Iwazaki H, Ida T. Quantitative analysis of age-related changes in vascular structure, oxygen saturation, and epidermal melanin structure using photoacoustic methods. Skin Res Technol 2024; 30:e13537. [PMID: 38174730 PMCID: PMC10765365 DOI: 10.1111/srt.13537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 11/09/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Vascular structure, blood oxygen saturation, and melanin status of the epidermis are chromophore factors related to light absorption. Therefore, they are likely to be related to skin appearance. Thus, it is important to measure these internal skin features and understand their characteristics. Thus, we aimed to analyze the individual differences and aging changes in the skin by measuring the internal skin characteristics, such as vascular structure, oxygen saturation, and the 3D distribution of melanin in the epidermis, using a noninvasive photoacoustic (PA) measurement method. MATERIALS AND METHODS A PA measurement device was used as a noninvasive measurement method. Eighty Japanese women aged between 20 and 60 years were enrolled. The target area was the buccal region of the face. RESULTS The blood vessel structure showed a decrease in fine vessels with age, with a stronger tendency observed in the dermis layer, and the volume of blood vessels was larger in the dermis layer than in the dermal-subcutaneous fat boundary layer. Oxygen saturation showed a similar decreasing trend with age in all depths examined. Melanin condition as the torus-like pattern structure tended to increase with age. CONCLUSION PA measurements revealed the characteristics of several chromophores, providing a new skin aging mechanism.
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Gupta S, Nagtode N, Chandra V, Gomase K. From Diagnosis to Treatment: Exploring the Latest Management Trends in Cervical Intraepithelial Neoplasia. Cureus 2023; 15:e50291. [PMID: 38205499 PMCID: PMC10776490 DOI: 10.7759/cureus.50291] [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: 09/11/2023] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
Cervical intraepithelial neoplasia (CIN) stands as a precancerous condition with the potential to progress to invasive cervical cancer. This comprehensive review explores the intricacies of CIN management, beginning with its definition, classification, and etiology. It emphasizes the significance of early detection and outlines the latest trends in diagnosis, including Pap smears, human papillomavirus (HPV) testing, and colposcopy. Grading and staging, pivotal in treatment selection, are elucidated. Current management approaches, encompassing watchful waiting, surgical interventions, emerging minimally invasive techniques, and immunotherapy, are detailed. The factors influencing treatment decisions, informed consent, and patient education are discussed. Potential complications following treatment, the importance of long-term follow-up, and the role of HPV vaccination in prevention are underscored. Finally, the review looks to the future, discussing advances in detection, novel treatments, and the promise of precision medicine. In conclusion, early detection and management remain the cornerstone of CIN care, offering hope for a future where cervical cancer is a preventable and treatable condition.
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Affiliation(s)
- Saloni Gupta
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nikhilesh Nagtode
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vaibhav Chandra
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Kavita Gomase
- Obstetrics and Gynecology, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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M B Zachary C, Grushchak S, Newman J. Skin Anatomy and Analysis. Facial Plast Surg Clin North Am 2023; 31:433-442. [PMID: 37806677 DOI: 10.1016/j.fsc.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
This article provides a comprehensive review and strong reference for facial and neck anatomy. An anatomic foundation is built for the dermatologic concepts, techniques, procedures, and surgeries detailed in noninvasive skin treatments. Superficial anatomic landmarks have been established that allow for more nuanced navigation and measurement of facial features. Throughout this article, we discuss key anatomic features of the face and neck, compare dermal thickness in various regions and ethnic anatomic differences, review insertion points of retaining ligaments of the superficial musculoaponeurotic system, and detail diagnostic tools including ultrasound and optical coherence tomography analysis of the skin.
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Affiliation(s)
- Cameron M B Zachary
- Department of Dermatology, University of California Irvine, 118 Med Surg 1, Building 810, Irvine, CA 92697, USA
| | - Solomiya Grushchak
- Department of Dermatology, University of California Irvine, 118 Med Surg 1, Building 810, Irvine, CA 92697, USA.
| | - James Newman
- Premier Plastic Surgery, 1795 El Camino Real, Suite 200, Palo Alto, CA 94306, USA
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Chen KJ, Han Y, Wang ZY, Cui Y. Submicron resolution techniques: Multiphoton microscopy in skin disease. Exp Dermatol 2023; 32:1613-1623. [PMID: 37522747 DOI: 10.1111/exd.14899] [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: 02/18/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
Non-invasive optical examination plays a crucial role in various aspects of dermatology, such as diagnosis, management and research. Multiphoton microscopy uses a unique submicron technology to stimulate autofluorescence (AF), allowing for the observation of cellular structure, assessment of redox status and quantification of collagen fibres. This advanced imaging technique offers dermatologists novel insights into the skin's structure, positioning it as a promising 'stethoscope' for future development in the field. This review provides an overview of multiphoton microscopy's principles, technology and application in studying normal skin, tumour and inflammatory diseases, as well as collagen-related and pigmentary diseases.
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Affiliation(s)
- Ke-Jun Chen
- Department of Dermatology, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yang Han
- Department of Dermatology, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zi-Yi Wang
- Department of Dermatology, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yong Cui
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
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8
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Shiu J, Lentsch G, Polleys CM, Mobasher P, Ericson M, Georgakoudi I, Ganesan AK, Balu M. Non-invasive Imaging Techniques for Monitoring Cellular Response to Treatment in Stable Vitiligo. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.15.553419. [PMID: 37645823 PMCID: PMC10462045 DOI: 10.1101/2023.08.15.553419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Punch grafting procedures, where small pieces of normal skin are transplanted into stable vitiligo patches, results in repigmentation in only half of patients treated, yet the factors that determine whether a patient responds to treatment or not are still unknown. Reflectance confocal microscopy (RCM) is adept at visualizing melanocyte migration and epidermal changes over large areas while multiphoton microscopy (MPM) can capture metabolic changes in keratinocytes. With the overall goal of identifying optical biomarkers for early treatment response, we followed 12 vitiligo lesions undergoing punch grafting. Dendritic melanocytes adjacent to the graft site were observed before clinical evidence of repigmentation in treatment responsive patients but not in treatment non-responsive patients, suggesting that the early visualization of melanocytes is indicative of a therapeutic response. Keratinocyte metabolic changes in vitiligo skin adjacent to the graft site also correlated with treatment response, indicating that a keratinocyte microenvironment that more closely resembles normal skin is more hospitable for migrating melanocytes. Taken together, these studies suggest that successful melanocyte transplantation requires both the introduction of new melanocytes and modulation of the local tissue microenvironment.
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Affiliation(s)
- Jessica Shiu
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Griffin Lentsch
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA, USA
| | | | - Pezhman Mobasher
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Marissa Ericson
- Biostatistics, Epidemiology and Research Design, University of California, Irvine, Irvine, CA, USA
| | - Irene Georgakoudi
- Department of Biological Chemistry, University of California, Irvine, Irvine, CA, USA
| | - Anand K Ganesan
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
- Department of Biological Chemistry, University of California, Irvine, Irvine, CA, USA
- Skin Biology Resource Center, University of California, Irvine, Irvine, CA, USA
| | - Mihaela Balu
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA, USA
- Skin Biology Resource Center, University of California, Irvine, Irvine, CA, USA
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9
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Setchfield K, Gorman A, Simpson AHRW, Somekh MG, Wright AJ. Relevance and utility of the in-vivo and ex-vivo optical properties of the skin reported in the literature: a review [Invited]. BIOMEDICAL OPTICS EXPRESS 2023; 14:3555-3583. [PMID: 37497524 PMCID: PMC10368038 DOI: 10.1364/boe.493588] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 07/28/2023]
Abstract
Imaging non-invasively into the human body is currently limited by cost (MRI and CT scan), image resolution (ultrasound), exposure to ionising radiation (CT scan and X-ray), and the requirement for exogenous contrast agents (CT scan and PET scan). Optical imaging has the potential to overcome all these issues but is currently limited by imaging depth due to the scattering and absorption properties of human tissue. Skin is the first barrier encountered by light when imaging non-invasively, and therefore a clear understanding of the way that light interacts with skin is required for progress on optical medical imaging to be made. Here we present a thorough review of the optical properties of human skin measured in-vivo and compare these to the previously collated ex-vivo measurements. Both in-vivo and ex-vivo published data show high inter- and intra-publication variability making definitive answers regarding optical properties at given wavelengths challenging. Overall, variability is highest for ex-vivo absorption measurements with differences of up to 77-fold compared with 9.6-fold for the in-vivo absorption case. The impact of this variation on optical penetration depth and transport mean free path is presented and potential causes of these inconsistencies are discussed. We propose a set of experimental controls and reporting requirements for future measurements. We conclude that a robust in-vivo dataset, measured across a broad spectrum of wavelengths, is required for the development of future technologies that significantly increase the depth of optical imaging.
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Affiliation(s)
- Kerry Setchfield
- Optics and Photonics Research Group, Faculty of Engineering, University of Nottingham, NG7 2RD, UK
| | | | - A Hamish R W Simpson
- Department of Orthopaedics, Division of Clinical and Surgical Sciences, University of Edinburgh, EH8 9YL, UK
| | - Michael G Somekh
- Optics and Photonics Research Group, Faculty of Engineering, University of Nottingham, NG7 2RD, UK
| | - Amanda J Wright
- Optics and Photonics Research Group, Faculty of Engineering, University of Nottingham, NG7 2RD, UK
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10
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Chen K, Wang Z, Han Y, Cui Y. In vivo detection of healthy skin: Comparison of multiphoton microscopy and reflectance confocal microscopy. Skin Res Technol 2023; 29:e13340. [PMID: 37231920 PMCID: PMC10156995 DOI: 10.1111/srt.13340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 04/19/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Noninvasive skin examination evolved rapidly in recent years, with multiphoton microscopy (MPM) and reflectance confocal microscopy (RCM) being used to image in-vivo skin at high resolution. The aim of this study is to compare the imaging clarity between the two techniques and measure the thickness of the epidermis in different body sites. We also measured the degree of skin aging with noninvasive tools. METHODS Fifty-six volunteers were evaluated and measured at three different body sites, including the cheek, volar forearm, and back. We used RCM and MPM to evaluate the clarity of each skin layer, including stratum corneum, stratum granulosum, stratum spinosum, dermo-epidermal junction, and dermis. We measured epidermal thickness (ET) at the three body sites in individuals of different ages and genders. We assessed skin aging by the second harmonic to autofluorescence aging index of dermis (SAAID), and multiple linear regression was used to analyze the factors affecting SAAID. RESULTS MPM had advantages in observation of stratum granulosum, collagen fiber, and elastic fiber (p < 0.001), but RCM provided better observation in dermo-epidermal junction layer (p < 0.001). The epidermis was thicker in the cheek area than the volar forearm and back in both RCM and MPM detection, and the average ET measured by MPM was lower than RCM. ET varied among the three body sites with significant differences (p < 0.05). ET was significantly lower at almost all sites in individuals above 40y (p < 0.05). SAAID decreased with age, and more rapidly in women. Cheeks have lower SAAID scores than other body sites. CONCLUSION MPM and RCM provide noninvasive methods for imaging skin and each method has its own advantages. Epidermal thickness and SAAID correlated with age, gender, and different body sites. MPM could also assess the degree of skin aging, which could guide the clinical treatment of patients with diffferent ages and genders in the above body sites.
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Affiliation(s)
- Ke‐Jun Chen
- Chinese Academy of Medical SciencesPeking Union Medical CollegeBeijingChina
- Department of DermatologyChina‐Japan Friendship HospitalBeijingChina
| | - Zi‐Yi Wang
- Chinese Academy of Medical SciencesPeking Union Medical CollegeBeijingChina
- Department of DermatologyChina‐Japan Friendship HospitalBeijingChina
| | - Yang Han
- Chinese Academy of Medical SciencesPeking Union Medical CollegeBeijingChina
- Department of DermatologyChina‐Japan Friendship HospitalBeijingChina
| | - Yong Cui
- Department of DermatologyChina‐Japan Friendship HospitalBeijingChina
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Diaz-Ramón JL, Gardeazabal J, Izu RM, Garrote E, Rasero J, Apraiz A, Penas C, Seijo S, Lopez-Saratxaga C, De la Peña PM, Sanchez-Diaz A, Cancho-Galan G, Velasco V, Sevilla A, Fernandez D, Cuenca I, Cortes JM, Alonso S, Asumendi A, Boyano MD. Melanoma Clinical Decision Support System: An Artificial Intelligence-Based Tool to Diagnose and Predict Disease Outcome in Early-Stage Melanoma Patients. Cancers (Basel) 2023; 15:cancers15072174. [PMID: 37046835 PMCID: PMC10093614 DOI: 10.3390/cancers15072174] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/17/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
This study set out to assess the performance of an artificial intelligence (AI) algorithm based on clinical data and dermatoscopic imaging for the early diagnosis of melanoma, and its capacity to define the metastatic progression of melanoma through serological and histopathological biomarkers, enabling dermatologists to make more informed decisions about patient management. Integrated analysis of demographic data, images of the skin lesions, and serum and histopathological markers were analyzed in a group of 196 patients with melanoma. The interleukins (ILs) IL-4, IL-6, IL-10, and IL-17A as well as IFNγ (interferon), GM-CSF (granulocyte and macrophage colony-stimulating factor), TGFβ (transforming growth factor), and the protein DCD (dermcidin) were quantified in the serum of melanoma patients at the time of diagnosis, and the expression of the RKIP, PIRIN, BCL2, BCL3, MITF, and ANXA5 proteins was detected by immunohistochemistry (IHC) in melanoma biopsies. An AI algorithm was used to improve the early diagnosis of melanoma and to predict the risk of metastasis and of disease-free survival. Two models were obtained to predict metastasis (including “all patients” or only patients “at early stages of melanoma”), and a series of attributes were seen to predict the progression of metastasis: Breslow thickness, infiltrating BCL-2 expressing lymphocytes, and IL-4 and IL-6 serum levels. Importantly, a decrease in serum GM-CSF seems to be a marker of poor prognosis in patients with early-stage melanomas.
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Affiliation(s)
- Jose Luis Diaz-Ramón
- Dermatology Service, Cruces University Hospital, 48903 Barakaldo, Spain
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - Jesus Gardeazabal
- Dermatology Service, Cruces University Hospital, 48903 Barakaldo, Spain
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - Rosa Maria Izu
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Dermatology Service, Basurto University Hospital, 48013 Bilbao, Spain
| | - Estibaliz Garrote
- TECNALIA, Basque Research and Technology Alliance (BRTA), 20850 Gipuzkoa, Spain
- Department of Cell Biology and Histology, University of the Basque Country/EHU, 48940 Leioa, Spain
| | - Javier Rasero
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Aintzane Apraiz
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country/EHU, 48940 Leioa, Spain
| | - Cristina Penas
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country/EHU, 48940 Leioa, Spain
| | - Sandra Seijo
- Ibermática Innovation Institute, 48170 Zamudio, Spain
| | | | | | - Ana Sanchez-Diaz
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Dermatology Service, Basurto University Hospital, 48013 Bilbao, Spain
| | - Goikoane Cancho-Galan
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Pathology Service, Basurto University Hospital, 48013 Bilbao, Spain
| | - Veronica Velasco
- Dermatology Service, Cruces University Hospital, 48903 Barakaldo, Spain
- Pathology Service, Cruces University Hospital, 48903 Barakaldo, Spain
| | - Arrate Sevilla
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country/EHU, 48940 Leioa, Spain
| | | | - Iciar Cuenca
- Ibermática Innovation Institute, 48170 Zamudio, Spain
| | - Jesus María Cortes
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country/EHU, 48940 Leioa, Spain
- IKERBASQUE, The Basque Foundation for Science, 48009 Bilbao, Spain
| | - Santos Alonso
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country/EHU, 48940 Leioa, Spain
| | - Aintzane Asumendi
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country/EHU, 48940 Leioa, Spain
| | - María Dolores Boyano
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Department of Cell Biology and Histology, University of the Basque Country/EHU, 48940 Leioa, Spain
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Sendín-Martín M, Posner J, Harris U, Moronta M, Conejo-Mir Sánchez J, Mukherjee S, Rajadhyaksha M, Kose K, Jain M. Quantitative collagen analysis using second harmonic generation images for the detection of basal cell carcinoma with ex vivo multiphoton microscopy. Exp Dermatol 2023; 32:392-402. [PMID: 36409162 PMCID: PMC10478030 DOI: 10.1111/exd.14713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/22/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer, and its incidence is rising. Millions of benign biopsies are performed annually for BCC diagnosis, increasing morbidity, and healthcare costs. Non-invasive in vivo technologies such as multiphoton microscopy (MPM) can aid in diagnosing BCC, reducing the need for biopsies. Furthermore, the second harmonic generation (SHG) signal generated from MPM can classify and prognosticate cancers based on extracellular matrix changes, especially collagen type I. We explored the potential of MPM to differentiate collagen changes associated with different BCC subtypes compared to normal skin structures and benign lesions. Quantitative analysis such as frequency band energy analysis in Fourier domain, CurveAlign and CT-FIRE fibre analysis was performed on SHG images from 52 BCC and 12 benign lesions samples. Our results showed that collagen distribution is more aligned surrounding BCCs nests compared to the skin's normal structures (p < 0.001) and benign lesions (p < 0.001). Also, collagen was orientated more parallelly surrounding indolent BCC subtypes (superficial and nodular) versus those with more aggressive behaviour (infiltrative BCC) (p = 0.021). In conclusion, SHG signal from type I collagen can aid not only in the diagnosis of BCC but could be useful for prognosticating these tumors. Our initial results are limited to a small number of samples, requiring large-scale studies to validate them. These findings represent the groundwork for future in vivo MPM for diagnosis and prognosis of BCC.
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Affiliation(s)
- Mercedes Sendín-Martín
- Hospital Universitario Virgen del Rocío, Dermatology Department, Sevilla (Spain)
- Universidad de Sevilla, Department of Medicine, Sevilla (Spain)
| | - Jasmine Posner
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
| | - Ucalene Harris
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
| | - Matthew Moronta
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
| | - Julián Conejo-Mir Sánchez
- Hospital Universitario Virgen del Rocío, Dermatology Department, Sevilla (Spain)
- Universidad de Sevilla, Department of Medicine, Sevilla (Spain)
| | - Sushmita Mukherjee
- Weill Cornell Medicine, Dermatology Service, Department of Medicine, New York (USA)
| | - Milind Rajadhyaksha
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
| | - Kivanc Kose
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
| | - Manu Jain
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
- Weill Cornell Medicine, Dermatology Service, Department of Medicine, New York (USA)
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Ching-Roa VD, Huang CZ, Ibrahim SF, Smoller BR, Giacomelli MG. Real-time Analysis of Skin Biopsy Specimens With 2-Photon Fluorescence Microscopy. JAMA Dermatol 2022; 158:1175-1182. [PMID: 36069886 PMCID: PMC9453637 DOI: 10.1001/jamadermatol.2022.3628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Importance Nonmelanoma skin cancers (NMSCs) are primarily diagnosed through paraffin section histologic analysis of skin biopsy specimens that requires days to weeks before a formal diagnosis is reported. Two-photon fluorescence microscopy (TPFM) has the potential for point-of-care diagnosis of NMSC and other dermatologic conditions, which could enable same-visit diagnosis and treatment. Objective To demonstrate that TPFM imaging of NMSC can occur within minutes of obtaining biopsies and provide similar histological features to those of conventional histology and evaluate TPFM diagnostic performance with respect to conventional histology. Design, Setting, and Participants This comparative effectiveness pilot study examined 29 freshly excised biopsies from confirmed NMSC lesions in patients presenting for treatment. Biopsies underwent imaging immediately with TPFM on site at Rochester Dermatologic Surgery (Victor, New York) between October 2019 and August 2021. The imaged biopsies were subsequently submitted for paraffin histology to produce coregistered images. Twelve of these coregistered image pairs (41.4%) were used as a training set. Fifteen (51.7%) were used in a masked evaluation by a board-certified dermatopathologist. Two (6.9%) were excluded from the study before evaluation because they could not be coregistered. Main Outcomes and Measures Sensitivity, specificity, and accuracy of TPFM for NMSC biopsies were evaluated compared with conventional histology. Results Fourteen of the 15 biopsy specimens (93.3%) in the evaluation set were identically diagnosed with TPFM and paraffin histology. The TPFM had 100% sensitivity (95% CI, 48%-100%), 100% specificity (95% CI, 69%-100%), and 100% accuracy (95% CI, 78%-100%) for basal cell carcinoma diagnosis. For squamous cell carcinoma diagnosis, TPFM had 89% sensitivity (95% CI, 52%-100), 100% specificity (95% CI, 54%-100%), and 93% accuracy (95% CI, 68%-100%). For overall NMSC diagnosis, TPFM had a 93% sensitivity (95% CI, 66%-100%), 100% specificity (95% CI, 3%-100%), and 93% accuracy (95% CI, 68%-100%). Examination of the 1 discordant pair revealed mismatched imaging planes as the source of error. Conclusions and Relevance The results of this comparative effectiveness pilot study suggest that TPFM captures histological characteristics of NMSC that are present in conventional histology, which reveals its potential as a rapid, point-of-care diagnostic alternative that does not need extensive sample preparation or retraining for image evaluation. Further validation of TPFM imaging performed for a larger cohort is needed to fully evaluate its diagnostic accuracy and potential effect within the field.
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Affiliation(s)
- Vincent D. Ching-Roa
- Department of Biomedical Engineering, University of Rochester, Rochester, New York
| | - Chi Z. Huang
- Department of Biomedical Engineering, University of Rochester, Rochester, New York
| | - Sherrif F. Ibrahim
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York,Rochester Dermatologic Surgery, PC, Victor, New York
| | - Bruce R. Smoller
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York
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