Morphologic criteria of vesiculobullous skin disorders by in vivo reflectance confocal microscopy

Reflectance Confocal Microscopy, Optical Coherence Tomography, and Multiphoton Microscopy in Inflammatory Skin Disease Diagnosis

BACKGROUND AND OBJECTIVES

Technological advances in medicine have brought about many novel skin imaging devices. This review aims to evaluate the scientific evidence supporting the use of noninvasive optical imaging techniques to aid in the diagnosis and prognosis of inflammatory skin diseases.

STUDY DESIGN/MATERIALS AND METHODS

PubMed and Scopus were searched in September 2020 according to PRISMA guidelines for articles using reflectance confocal microscopy (RCM), optical coherence tomography (OCT), and multiphoton microscopy (MPM) in inflammatory skin diseases, excluding studies monitoring treatment efficacy.

RESULTS

At the time of the study, there were 66 articles that addressed the utilization of noninvasive imaging in interface, spongiotic, psoriasiform, vesiculobullous, and fibrosing/sclerosing inflammatory skin dermatoses: RCM was utilized in 46, OCT in 16, and MPM in 5 articles. RCM was most investigated in psoriasiform dermatoses, whereas OCT and MPM were both most investigated in spongiotic dermatoses, including atopic dermatitis and allergic contact dermatitis.

CONCLUSIONS

There is preliminary evidence to support the diagnostic potential of noninvasive optical imaging techniques in inflammatory skin diseases. Improvements in the devices and further correlation with histology will help broaden their utility. Additional studies are needed to determine the parameters for diagnostic features, disease differentiation, and staging of inflammatory skin conditions. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.

[Reflectance confocal microscopy in Shiitake dermatitis]

Shiitake dermatitis usually occurs 1-2 days after consumption of incompletely cooked or raw shiitake mushrooms and is characterized by linear, pruritic, erythematous papulovesicular rashes. It is caused by lentinan, a polysaccharide component of the cell walls of shiitake mushrooms. The histological examination showed an eczema-like morphology with spongiosis and lymphohistiocytic infiltrates. The results of reflectance confocal microscopy (RCM) correlated with the histopathological investigations. Therefore, RCM can be used for non-invasive diagnostic confirmation of Shiitake dermatitis in the future.