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Benavides-Lara J, Siegel AP, Tsoukas MM, Avanaki K. High-frequency photoacoustic and ultrasound imaging for skin evaluation: Pilot study for the assessment of a chemical burn. JOURNAL OF BIOPHOTONICS 2024; 17:e202300460. [PMID: 38719468 DOI: 10.1002/jbio.202300460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 07/13/2024]
Abstract
Skin architecture and its underlying vascular structure could be used to assess the health status of skin. A non-invasive, high resolution and deep imaging modality able to visualize skin subcutaneous layers and vasculature structures could be useful for determining and characterizing skin disease and trauma. In this study, a multispectral high-frequency, linear array-based photoacoustic/ultrasound (PAUS) probe is developed and implemented for the imaging of rat skin in vivo. The study seeks to demonstrate the probe capabilities for visualizing the skin and its underlying structures, and for monitoring changes in skin structure and composition during a 5-day course of a chemical burn. We analayze composition of lipids, water, oxy-hemoglobin, and deoxy-hemoglobin (for determination of oxygen saturation) in the skin tissue. The study successfully demonstrated the high-frequency PAUS imaging probe was able to provide 3D images of the rat skin architecture, underlying vasculature structures, and oxygen saturation, water, lipids and total hemoglobin.
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Affiliation(s)
- Juliana Benavides-Lara
- The Richard and Loan Hill Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Amanda P Siegel
- The Richard and Loan Hill Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Maria M Tsoukas
- Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kamran Avanaki
- The Richard and Loan Hill Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois, USA
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2
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Lotz S, Göb M, Böttger S, Ha-Wissel L, Hundt J, Ernst F, Huber R. Large area robotically assisted optical coherence tomography (LARA-OCT). BIOMEDICAL OPTICS EXPRESS 2024; 15:3993-4009. [PMID: 38867778 PMCID: PMC11166428 DOI: 10.1364/boe.525524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 06/14/2024]
Abstract
We demonstrate large-area robotically assisted optical coherence tomography (LARA-OCT), utilizing a seven-degree-of-freedom robotic arm in conjunction with a 3.3 MHz swept-source OCT to raster scan samples of arbitrary shape. By combining multiple fields of view (FOV), LARA-OCT can probe a much larger area than conventional OCT. Also, nonplanar and curved surfaces like skin on arms and legs can be probed. The lenses in the LARA-OCT scanner with their normal FOV can have fewer aberrations and less complex optics compared to a single wide field design. This may be especially critical for high resolution scans. We directly use our fast MHz-OCT for tracking and stitching, making additional machine vision systems like cameras, positioning, tracking or navigation devices obsolete. This also eliminates the need for complex coordinate system registration between OCT and the machine vision system. We implemented a real time probe-to-surface control that maintains the probe alignment orthogonal to the sample by only using surface information from the OCT images. We present OCT data sets with volume sizes of 140 × 170 × 20 mm3, captured in 2.5 minutes.
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Affiliation(s)
- Simon Lotz
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, 23562 Lübeck, Germany
| | - Madita Göb
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, 23562 Lübeck, Germany
| | - Sven Böttger
- Institute for Robotic and Cognitive Systems, Universität zu Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
- qtec Services GmbH, Niels-Bohr-Ring 3-5, 23568 Lübeck, Germany
| | - Linh Ha-Wissel
- Lübeck Institute of Experimental Dermatology, Universität zu Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
- Department of Dermatology, Allergology, Venerology, University Hospital of Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Jennifer Hundt
- Lübeck Institute of Experimental Dermatology, Universität zu Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Floris Ernst
- Institute for Robotic and Cognitive Systems, Universität zu Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Robert Huber
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, 23562 Lübeck, Germany
- Medizinisches Laserzentrum Lübeck GmbH, Peter-Monnik-Weg 4, 23562 Lübeck, Germany
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3
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Lu LY, Chen YT, Chen IL, Shih YC, Liu RTL, Lai YJ, Ng CY. Feasibility of High-Cellular-Resolution Full-Field, Artificial-Intelligence-Assisted, Real-Time Optical Coherence Tomography in the Evaluation of Vitiligo: A Prospective Longitudinal Follow-Up Study. Bioengineering (Basel) 2024; 11:196. [PMID: 38391682 PMCID: PMC10886376 DOI: 10.3390/bioengineering11020196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/24/2024] Open
Abstract
Vitiligo, a psychologically distressing pigmentary disorder characterized by white depigmented patches due to melanocyte loss, necessitates non-invasive tools for early detection and treatment response monitoring. High-cellular-resolution full-field optical coherence tomography (CRFF-OCT) is emerging in pigmentary disorder assessment, but its applicability in vitiligo repigmentation after tissue grafting remains unexplored. To investigate the feasibility of CRFF-OCT for evaluating vitiligo lesions following tissue grafting, our investigation involved ten vitiligo patients who underwent suction blister epidermal grafting and laser ablation at a tertiary center between 2021 and 2022. Over a six-month period, clinical features, dermoscopy, and photography data were recorded. Utilizing CRFF-OCT along with artificial intelligence (AI) applications, repigmentation features were captured and analyzed. The CRFF-OCT analysis revealed a distinct dark band in vitiligo lesion skin, indicating melanin loss. Grafted areas exhibited melanocytes with dendrites around the epidermal-dermal junction and hair follicles. CRFF-OCT demonstrated its efficacy in the early detection of melanocyte recovery and accurate melanin quantification. This study introduces CRFF-OCT as a real-time, non-invasive, and in vivo evaluation tool for assessing vitiligo repigmentation, offering valuable insights into pigmentary disorders and treatment responses.
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Affiliation(s)
- Lai-Ying Lu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 333423, Taiwan
- Department of Dermatology and Aesthetic Medicine Center, Jen-Ai Hospital, Taichung 412224, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
| | | | - I-Ling Chen
- Apollo Medical Optics, Ltd., Taipei 114, Taiwan
| | | | - Rosalie Tzu-Li Liu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 333423, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Vitiligo Clinic and Pigment Research Center, Chang Gung Memorial Hospital, Linkou District, New Taipei 33305, Taiwan
| | - Yi-Jing Lai
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 333423, Taiwan
- Vitiligo Clinic and Pigment Research Center, Chang Gung Memorial Hospital, Linkou District, New Taipei 33305, Taiwan
| | - Chau Yee Ng
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 333423, Taiwan
- Department of Dermatology and Aesthetic Medicine Center, Jen-Ai Hospital, Taichung 412224, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Apollo Medical Optics, Ltd., Taipei 114, Taiwan
- Vitiligo Clinic and Pigment Research Center, Chang Gung Memorial Hospital, Linkou District, New Taipei 33305, Taiwan
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4
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Starace M, Cedirian S, Alessandrini A, Bruni F, Piraccini BM, Iorizzo M. Self-induced nail disorders (SINDs): What do we know so far? Ann Dermatol Venereol 2023; 150:253-259. [PMID: 37813711 DOI: 10.1016/j.annder.2023.05.005] [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: 01/29/2023] [Revised: 03/17/2023] [Accepted: 05/09/2023] [Indexed: 10/11/2023]
Abstract
Self-induced nail disorders are a broad group of different clinical manifestations that share the common trait of being caused more or less voluntarily by the patient. These are distinct conditions within the clinical spectrum of onychotillomania. Most patients diagnosed with these disorders have psychiatric co-morbidities, and a multidisciplinary approach is thus highly recommended. The purpose of this review is to describe the most common clinical features encountered during daily nail consultations and to provide useful diagnostic tools and therapeutic tips for the best approach to these conditions.
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Affiliation(s)
- M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - S Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy.
| | - A Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - F Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - M Iorizzo
- Private Dermatology Practice, Lugano/Bellinzona, Switzerland
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Xu J, Yuan X, Huang Y, Qin J, Lan G, Qiu H, Yu B, Jia H, Tan H, Zhao S, Feng Z, An L, Wei X. Deep-learning visualization enhancement method for optical coherence tomography angiography in dermatology. JOURNAL OF BIOPHOTONICS 2023; 16:e202200366. [PMID: 37289020 DOI: 10.1002/jbio.202200366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/20/2023] [Accepted: 05/21/2023] [Indexed: 06/09/2023]
Abstract
Optical coherence tomography angiography (OCTA) in dermatology usually suffers from low image quality due to the highly scattering property of the skin, the complexity of cutaneous vasculature, and limited acquisition time. Deep-learning methods have achieved great success in many applications. However, the deep learning approach to improve dermatological OCTA images has not been investigated due to the requirement of high-performance OCTA systems and difficulty of obtaining high-quality images as ground truth. This study aims to generate proper datasets and develop a robust deep learning method to enhance the skin OCTA images. A swept-source skin OCTA system was employed to create low-quality and high-quality OCTA images with different scanning protocols. We propose a model named vascular visualization enhancement generative adversarial network and adopt an optimized data augmentation strategy and perceptual content loss function to achieve better image enhancement effect with small amount of training data. We demonstrate the superiority of the proposed method in skin OCTA image enhancement by quantitative and qualitative comparisons.
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Affiliation(s)
- Jingjiang Xu
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Provincial Pearl River Talents Program, Guangdong Weiren Meditech Co. Ltd, Foshan, Guangdong, China
| | - Xing Yuan
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, Guangdong, China
| | - Yanping Huang
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Provincial Pearl River Talents Program, Guangdong Weiren Meditech Co. Ltd, Foshan, Guangdong, China
| | - Jia Qin
- Innovation and Entrepreneurship Teams Project of Guangdong Provincial Pearl River Talents Program, Guangdong Weiren Meditech Co. Ltd, Foshan, Guangdong, China
- Department of Ophthalmology, Clinical Medical Institute, Affiliated Hospital, Weifang Medical University, Weifang, Shandong, China
| | - Gongpu Lan
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
- Innovation and Entrepreneurship Teams Project of Guangdong Provincial Pearl River Talents Program, Guangdong Weiren Meditech Co. Ltd, Foshan, Guangdong, China
| | - Haixia Qiu
- Department of Laser Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Bo Yu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Haibo Jia
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Haishu Tan
- Guangdong-Hong Kong-Macao Joint Laboratory for Intelligent Micro-Nano Optoelectronic Technology, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, China
| | - Shiyong Zhao
- Tianjin Hengyu Medical Technology Co., Ltd., Tianjin, China
| | - Zhongwu Feng
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, Guangdong, China
| | - Lin An
- Innovation and Entrepreneurship Teams Project of Guangdong Provincial Pearl River Talents Program, Guangdong Weiren Meditech Co. Ltd, Foshan, Guangdong, China
- Department of Ophthalmology, Clinical Medical Institute, Affiliated Hospital, Weifang Medical University, Weifang, Shandong, China
| | - Xunbin Wei
- Biomedical Engineering Department, Peking University, Beijing, China
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6
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Ha-Wissel L, Yasak H, Huber R, Zillikens D, Ludwig RJ, Thaçi D, Hundt JE. Case report: Optical coherence tomography for monitoring biologic therapy in psoriasis and atopic dermatitis. Front Med (Lausanne) 2022; 9:995883. [PMID: 36237538 PMCID: PMC9551172 DOI: 10.3389/fmed.2022.995883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Biologic therapies are increasingly used to treat chronic inflammatory skin diseases such as psoriasis and atopic dermatitis. In clinical practice, scores based on evaluation of objective and subjective symptoms are used to assess disease severity, leading to evaluation of treatment goals with clinical decisions on treatment initiation, switch to another treatment modality or to discontinue current treatment. However, this visual-based scoring is relatively subjective and inaccurate due to inter- and intraobserver reliability. Optical coherence tomography (OCT) is a fast, high-resolution, in vivo imaging modality that enables the visualization of skin structure and vasculature. We evaluated the use of OCT for quantification and monitoring of skin inflammation to improve objective assessment of disease activity in patients with psoriasis and atopic dermatitis. We assessed the following imaging parameters including epidermal thickness, vascular density, plexus depth, vessel diameter, and vessel count. A total of four patients with psoriasis or atopic dermatitis were treated with biologic agents according to current treatment guidelines. OCT was used to monitor their individual treatment response in a target lesion representing disease activity for 52 weeks. Psoriatic and eczema lesions exhibited higher epidermal thickness, increased vascular density, and higher vessel count compared to uninvolved skin. An upward shift of the superficial vascular plexus accompanied by smaller vessel diameters was seen in psoriasis in contrast to atopic dermatitis, where larger vessels were observed. A response to biologic therapy was characterized by normalization of the imaging parameters in the target lesions in comparison to uninvolved skin during the observation period of 52 weeks. Optical coherence tomography potentially serves as an instrument to monitor biologic therapy in inflammatory skin diseases. Imaging parameters may enable objective quantification of inflammation in psoriasis or atopic dermatitis in selected representative skin areas. OCT may reveal persistent subclinical inflammation in atopic dermatitis beyond clinical remission.
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Affiliation(s)
- Linh Ha-Wissel
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein Lübeck (UKSH), Lübeck, Germany
- Institute for Inflammatory Medicine, University of Lübeck, Lübeck, Germany
- *Correspondence: Linh Ha-Wissel,
| | - Handan Yasak
- Institute for Inflammatory Medicine, University of Lübeck, Lübeck, Germany
| | - Robert Huber
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany
| | - Detlef Zillikens
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein Lübeck (UKSH), Lübeck, Germany
| | - Ralf J. Ludwig
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein Lübeck (UKSH), Lübeck, Germany
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Diamant Thaçi
- Institute for Inflammatory Medicine, University of Lübeck, Lübeck, Germany
| | - Jennifer E. Hundt
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
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7
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Ortner VK, Mandel VD, Bertugno S, Philipsen PA, Haedersdal M. Imaging of the Nail Unit in Psoriatic Patients - a Systematic Scoping Review of Techniques and Terminology. Exp Dermatol 2022; 31:828-840. [PMID: 35353919 PMCID: PMC9323418 DOI: 10.1111/exd.14572] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/14/2022] [Accepted: 03/26/2022] [Indexed: 11/28/2022]
Abstract
Background The growing interest in the visualization of psoriatic nail unit changes has led to the discovery of an abundance of image characteristics across various modalities. Objective To identify techniques for non‐invasive imaging of nail unit structures in psoriatic patients and review extracted image features to unify the diverse terminology. Methods For this systematic scoping review, we included studies available on PubMed and Embase, independently extracted image characteristics, and semantically grouped the identified features to suggest a preferred terminology for each technique. Results After screening 753 studies, 67 articles on the visualization of clinical and subclinical psoriatic changes in the nail plate, matrix, bed, folds and hyponychium were included. We identified 4 optical and 3 radiological imaging techniques for the assessment of surface (dermoscopy [n = 16], capillaroscopy [n = 12]), sub‐surface (ultrasound imaging [n = 36], optical coherence tomography [n = 4], fluorescence optical imaging [n = 3]), and deep‐seated psoriatic changes (magnetic resonance imaging [n = 2], positron emission tomography‐computed tomography [n = 1]). By condensing 244 image feature descriptions into a glossary of 82 terms, overall redundancy was cut by 66.4% (37.5%–77.1%). More than 75% of these image features provide additional disease‐relevant information that is not captured using conventional clinical assessment scales. Conclusions This review has identified, unified, and contextualized image features and related terminology for non‐invasive imaging of the nail unit in patients with psoriatic conditions. The suggested glossary could facilitate the integrative use of non‐invasive imaging techniques for the detailed examination of psoriatic nail unit structures in research and clinical practice.
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Affiliation(s)
- V K Ortner
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiskberg, Denmark
| | - V D 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.,Porphyria and Rare Diseases Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - S Bertugno
- Radiology Unit, Bernardino Ramazzini Hospital, Carpi, Italy
| | - P A Philipsen
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiskberg, Denmark
| | - M Haedersdal
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiskberg, Denmark
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8
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Abstract
During the past decade, noninvasive imaging has emerged as a valuable tool in clinical dermatology and dermatologic research. Optical coherence tomography (OCT) is one such type of noninvasive imaging. OCT uses the principle of interferometry to produce real-time images. A low-power diode laser shines infrared light onto tissues, which reflects back to an optical fiber interferometer. Using time delay and the backscattered light intensity, a two-dimensional image akin to an ultrasound is rendered. We review the history, types, and modalities of OCT, plus the many applications of frequency domain, high definition, and dynamic OCT in practice, including its utility in diagnosis, monitoring, and grading disease severity in a variety of cutaneous conditions.
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Affiliation(s)
- Corinna E Psomadakis
- Department of Medicine, Mount Sinai West and Morningside, New York, New York, USA
| | - Nadeem Marghoob
- University of Vermont Medical Center, Department of Dermatology, Burlington, VT
| | - Brady Bleicher
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Orit Markowitz
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA.
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9
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Ruini C, Daxenberger F, Gust C, Schuh S, French LE, Welzel J, Sattler EC. [Advances in optical coherence tomography]. Hautarzt 2021; 72:1048-1057. [PMID: 34698874 DOI: 10.1007/s00105-021-04905-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/29/2022]
Abstract
Optical coherence tomography (OCT) has been able to establish itself in recent years not only in academic-scientific, but also in everyday dermatological practice. Its focus lies on epithelial tumors of the skin, which can be diagnosed intuitively and within a few seconds. Thus, basal cell carcinomas, actinic keratoses, and different stages of field cancerization can be diagnosed and monitored for response to therapy or possible recurrence. This often helps to avoid invasive sample extraction. Recently, the field of OCT and its latest advancement, dynamic OCT (D-OCT), has been expanded to include non-oncologic dermatological diseases. This encompasses inflammatory dermatoses and the analysis of physiological skin parameters such as hydration. Thanks to automated vascular imaging and the measurement of objective parameters such as epidermal thickness, blood flow at depth, optical attenuation coefficient, and skin roughness, more and more characteristics of the skin can be studied in a noninvasive and standardized way. New potential areas of application are eczema, contact allergic dermatitis, psoriasis, rosacea, telangiectasia, acute and chronic wounds, melasma and nevus flammeus but also melanocytic lesions.
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Affiliation(s)
- Cristel Ruini
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland. .,Doctorate School (PhD) in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italien.
| | - Fabia Daxenberger
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Charlotte Gust
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Sandra Schuh
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Lars E French
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, USA
| | - Julia Welzel
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Elke C Sattler
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
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10
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Guldberg-Møller J, Henriksen M, Ellegaard K, Haedersdal M, Lazar LT, Kristensen LE, Mogensen M. Novel application of optical coherence tomography and capillaroscopy in psoriatic arthritis in relationship to psoriasis and hand osteoarthritis. Rheumatol Adv Pract 2021; 5:rkab065. [PMID: 34622126 PMCID: PMC8493103 DOI: 10.1093/rap/rkab065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/18/2021] [Indexed: 11/12/2022] Open
Abstract
Objectives Nailfold video capillaroscopy (NVC) and angiographic optical coherence tomography (OCTA) have potential in diagnosing PsA and differentiating it from psoriasis vulgaris (PsO) and hand OA. We aimed to assess the diagnostic properties of NVC and OCTA in patients with PsA compared with patients with PsO and hand OA based on nailfold capillary patterns. Methods Patients with DIP joint PsA and nail involvement (n = 50), PsO with nail involvement (n = 12) and OA (n = 13) were included in this cross-sectional study. Capillaries were evaluated semi-quantitatively and qualitatively. Differences in capillary findings between groups were assessed using mixed linear models. Binary logistic regression analyses were performed to determine the probability for PsA diagnosis based on capillaroscopy findings. Results Below mean capillary density and reduced nailfold blood flow in OCTA images distinguished PsA from both PsO (P = 0.004 and P = 0.052, respectively) and OA (P = 0.024 and P < 0.001, respectively). Qualitative analysis revealed that glomerular capillaries were found in only 3% of PsA patients but in 13% of PsO patients (P = 0.003). Furthermore, crossed vessels were seen in only 55% of PsA patients and 71% of PsO patients (P = 0.043). NVC microhaemorrhage was dominant in PsA patients (13%) and significantly different from OA patients (P <0.05). No capillary pattern was associated with an increased probability of the PsA diagnosis. Conclusion A pathognomonic pattern for PsA diagnosis was not identified; however, we demonstrated some characteristic capillaroscopy findings for PsA, such as decreased capillary density, reduced blood flow and fewer crossed vessels in OCTA and presence of NVC microhaemorrhages.
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Affiliation(s)
- Jørgen Guldberg-Møller
- The Parker Institute, Bispebjerg and Frederiksberg University Hospitals.,Department of Rheumatology, Slagelse Sygehus, Zealand University Hospitals, Slagelse
| | - Marius Henriksen
- The Parker Institute, Bispebjerg and Frederiksberg University Hospitals
| | - Karen Ellegaard
- The Parker Institute, Bispebjerg and Frederiksberg University Hospitals
| | - Merete Haedersdal
- Department of Dermatology, University Hospitals of Copenhagen, Bispebjerg and Frederiksberg Copenhagen, Denmark
| | - Luna T Lazar
- Department of Dermatology, University Hospitals of Copenhagen, Bispebjerg and Frederiksberg Copenhagen, Denmark
| | | | - Mette Mogensen
- Department of Dermatology, University Hospitals of Copenhagen, Bispebjerg and Frederiksberg Copenhagen, Denmark
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11
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[Optical coherence tomography for the differential diagnosis of unclear nail pigmentation]. Hautarzt 2021; 73:379-383. [PMID: 34269835 DOI: 10.1007/s00105-021-04862-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 10/20/2022]
Abstract
In daily practice, nail pigmentation can be a diagnostic challenge, especially if the dermoscopic findings are nonspecific. We present examples of cases, in which optical coherence tomography-a rapid, noninvasive imaging method-showed typical changes that were indicative for the diagnosis.
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12
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Kaeley GS, Eder L, Aydin SZ, Rich P, Bakewell CJ. Nail Psoriasis: Diagnosis, Assessment, Treatment Options, and Unmet Clinical Needs. J Rheumatol 2021; 48:1208-1220. [PMID: 33589557 DOI: 10.3899/jrheum.201471] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE An estimated 40-50% of patients with psoriasis (PsO) have psoriatic nail disease, which is associated with and directly contributes to a greater clinical burden and worse quality of life in these patients. In this review, we examine how recent advances in the use of new diagnostic techniques have led to improved understanding of the link between nail and musculoskeletal manifestations of psoriatic disease (PsD; e.g., enthesitis, arthritis) and we review targeted therapies for nail PsO (NP). METHODS We performed a literature search to identify which systemic therapies approved for the treatment of PsO and/or psoriatic arthritis (PsA) have been evaluated for the treatment of NP, either as a primary or secondary outcome. A total of 1546 articles were identified on February18, 2019, and evaluated for relevance. RESULTS We included findings from 66 articles on systemic therapies for the treatment of NP in PsD. With several scoring systems available for the evaluation of psoriatic nail disease, including varied subtypes and application of the Nail Psoriasis Area Severity Index, there was a high level of methodological heterogeneity across studies. CONCLUSION NP is an important predictor of enthesitis, which is associated with the early stages of PsA; therefore, it is important for rheumatologists and dermatologists to accurately diagnose and treat NP to prevent nail damage and potentially delay the onset and progression of joint disease. Further research is needed to address the lack of both standardized NP scoring systems and well-defined treatment guidelines to improve management of PsD.
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Affiliation(s)
- Gurjit S Kaeley
- G.S. Kaeley, MRCP, Department of Medicine, University of Florida College of Medicine, Division of Rheumatology, Jacksonville, Florida, USA;
| | - Lihi Eder
- L. Eder, MD, PhD, University of Toronto, Women's College Research Institute, Toronto, Ontario, Canada
| | - Sibel Zehra Aydin
- S.Z. Aydin, MD, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Phoebe Rich
- P. Rich, MD, Oregon Dermatology & Research Center, Portland, Oregon, USA
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13
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Saleah SA, Kim P, Seong D, Wijesinghe RE, Jeon M, Kim J. A preliminary study of post-progressive nail-art effects on in vivo nail plate using optical coherence tomography-based intensity profiling assessment. Sci Rep 2021; 11:666. [PMID: 33436674 PMCID: PMC7804019 DOI: 10.1038/s41598-020-79497-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/11/2020] [Indexed: 01/29/2023] Open
Abstract
Nail beautification is a widely applied gender independent practice. Excessive nail beautifications and nail-arts have a direct impact on the nail structure and can cause nail disorders. Therefore, the assessment of post-progressive nail-art effects on the nail is essential to maintain optimal nail health and to avoid any undesirable disorders. In this study, in vivo nails were examined in control stage, with a nail-art stage, and after removing the nail-art stage using a 1310 nm spectral-domain optical coherence tomography (SD-OCT) system. The acquired cross-sectional OCT images were analyzed by a laboratory customized signal processing algorithm to obtain scattered intensity profiling assessments that could reveal the effects of nail beautification on the nail plate. The formation and progression of cracks on the nail plate surface were detected as an effect of nail beautification after 72 h of nail-art removal. Changes in backscattered light intensity and nail plate thickness of control and art-removed nails were quantitatively compared. The results revealed the potential feasibility of the developed OCT-based inspection procedure to diagnose post-progressive nail-art effects on in vivo nail plate, which can be helpful to prevent nail plate damages during art removal through real-time monitoring of the boundary between the nail plate and nail-art. Besides nail-art effects, the developed method can also be used for the investigation of nail plate abnormalities by examining the inconsistency of internal and external nail plate structure, which can be diagnosed with both qualitative and quantitative assessments from a clinical perspective.
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Affiliation(s)
- Sm Abu Saleah
- grid.258803.40000 0001 0661 1556School of Electronic and Electrical Engineering, College of IT Engineering, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu, 41566 South Korea
| | - Pilun Kim
- grid.464630.30000 0001 0696 9566Production Engineering Research Institute, LG Electronics, 17790, 222 LG-ro Jinwi-myeon, Pyeongtaek-si, Gyeonggi-do South Korea
| | - Daewoon Seong
- grid.258803.40000 0001 0661 1556School of Electronic and Electrical Engineering, College of IT Engineering, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu, 41566 South Korea
| | - Ruchire Eranga Wijesinghe
- grid.267198.30000 0001 1091 4496Department of Materials and Mechanical Technology, Faculty of Technology, University of Sri Jayewardenepura, Pitipana, Homagama, 10200 Sri Lanka
| | - Mansik Jeon
- grid.258803.40000 0001 0661 1556School of Electronic and Electrical Engineering, College of IT Engineering, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu, 41566 South Korea
| | - Jeehyun Kim
- grid.258803.40000 0001 0661 1556School of Electronic and Electrical Engineering, College of IT Engineering, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu, 41566 South Korea
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14
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Imaging Motion: A Comprehensive Review of Optical Coherence Tomography Angiography. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1310:343-365. [PMID: 33834441 DOI: 10.1007/978-981-33-6064-8_12] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Optical coherence tomography (OCT) is a three-dimensional (3-D) optical imaging technology that provides noninvasive, micrometer resolution images of structural interiors within biological samples with an approximately 1 ~ 2 mm penetration depth. Over the last decades, advances in OCT have revolutionized biomedical imaging by demonstrating a potential of optical biopsy in preclinical and clinical settings. Recently, functional OCT imaging has shown a promise as angiography to visualize cell-perfused vasculatures in the tissue bed in vivo without requiring any exogenous contrast agents. This new technology termed OCT angiography (OCTA) possesses a unique imaging capability of delineating tissue morphology and blood or lymphatic vessels down to capillaries at real-time acquisition rates. For the past 10 years since 2007, OCTA has been proven to be a useful tool to identify disorder or dysfunction in tissue microcirculation from both experimental animal studies and clinical studies in ophthalmology and dermatology. In this section, we overview about OCTA including a basic principle of OCTA explained with simple optical physics, and its scan protocols and post-processing algorithms for acquisition of angiography. Then, potential and challenge of OCTA for clinical settings are shown with outcomes of human studies.
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15
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Wan B, Ganier C, Du-Harpur X, Harun N, Watt FM, Patalay R, Lynch MD. Applications and future directions for optical coherence tomography in dermatology. Br J Dermatol 2020; 184:1014-1022. [PMID: 32974943 DOI: 10.1111/bjd.19553] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 12/24/2022]
Abstract
Optical coherence tomography (OCT) is a noninvasive optical imaging method that can generate high-resolution en face and cross-sectional images of the skin in vivo to a maximum depth of 2 mm. While OCT holds considerable potential for noninvasive diagnosis and disease monitoring, it is poorly understood by many dermatologists. Here we aim to equip the practising dermatologist with an understanding of the principles of skin OCT and the potential clinical indications. We begin with an introduction to the technology and discuss the different modalities of OCT including angiographic (dynamic) OCT, which can image cutaneous blood vessels at high resolution. Next we review clinical applications. OCT has been most extensively investigated in the diagnosis of keratinocyte carcinomas, particularly basal cell carcinoma. To date, OCT has not proven sufficiently accurate for the robust diagnosis of malignant melanoma; however, the evaluation of abnormal vasculature with angiographic OCT is an area of active investigation. OCT, and in particular angiographic OCT, also shows promise in monitoring the response to therapy of inflammatory dermatoses, such as psoriasis and connective tissues disease. We additionally discuss a potential role for artificial intelligence in improving the accuracy of interpretation of OCT imaging data.
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Affiliation(s)
- B Wan
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - C Ganier
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - X Du-Harpur
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK.,The Francis Crick Institute, 1 Midland Road, London, UK
| | - N Harun
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - F M Watt
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK
| | - R Patalay
- St John's Institute of Dermatology, King's College London, London, UK
| | - M D Lynch
- Centre for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, Great Maze Pond, London, UK.,St John's Institute of Dermatology, King's College London, London, UK
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16
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Ortner VK, Mandel VD, Haedersdal M, Philipsen PA. Impregnation of healthy nail tissue with optical clearing agents for improved optical coherence tomography imaging. Skin Res Technol 2020; 27:178-182. [PMID: 32681563 DOI: 10.1111/srt.12923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/20/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The impact of optical tissue clearing on optical coherence tomography (OCT) for nail tissue imaging has not been investigated. This study seeks to compare the effects of an emollient and water on visualization of micromorphology and morphometric outcomes. MATERIALS AND METHODS Thirty-six healthy nail plates were processed with a fractional CO2 laser, imaged with OCT, and measured with calipers in duplicates. All samples were reassessed after 12-hour long sequential immersion in water and an emollient (Crodamol™ STS). OCT images were evaluated for thickness and scattering signal of the nail. RESULTS Emollient-impregnation caused stronger scatter responses (P < .0001) and decreased nail thickness (MD 45 μm, P < .0001) measured on OCT. Caliper-derived measurements were not affected by Crodamol™ (MD 11 μm, P = .5538). Hydration increased nail thickness on OCT (MD 49 μm, P < .0001) but reduced thickness measurements taken with calipers (MD 41 μm, P < .0001). Emollient-impregnation improved visualization of onychocytes compared with dry (P = .0209) and hydrated samples (P < .0001), and reduced occurrence of refractive artifacts (P < .0001). CONCLUSION The use of an emollient for OCT imaging can enhance nail tissue visualization without significant effects on caliper measurements. Hydration of nails, in contrast with emollient-impregnation, may lead to disagreement between caliper- and OCT-measured nail thickness and should be practiced cautiously.
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Affiliation(s)
- Vinzent Kevin Ortner
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - 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.,Dermatology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Merete Haedersdal
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Peter Alshede Philipsen
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
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17
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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.
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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
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18
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Liu M, Drexler W. Optical coherence tomography angiography and photoacoustic imaging in dermatology. Photochem Photobiol Sci 2019; 18:945-962. [PMID: 30735220 DOI: 10.1039/c8pp00471d] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Optical coherence tomography angiography (OCTA) is a relatively novel functional extension of the widely accepted ophthalmic imaging tool named optical coherence tomography (OCT). Since OCTA's debut in ophthalmology, researchers have also been trying to expand its translational application in dermatology. The ability of OCTA to resolve microvasculature has shown promising results in imaging skin diseases. Meanwhile, photoacoustic imaging (PAI), which uses laser pulse induced ultrasound waves as the signal, has been studied to differentiate human skin layers and to help in skin disease diagnosis. This perspective article gives a short review of OCTA and PAI in the field of photodermatology. After an introduction to the principles of OCTA and PAI, we describe the most updated results of skin disease imaging using these two optical imaging modalities. We also place emphasis on dual modality imaging combining OCTA and photoacoustic tomography (PAT) for dermatological applications. In the end, the challenges and prospects of these two imaging modalities in dermatology are discussed.
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Affiliation(s)
- Mengyang Liu
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria.
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19
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Rajabi-Estarabadi A, Eber AE, Tsatalis J, Vazquez T, Perper M, Nouri K, Tosti A. Optical coherence tomography in evaluation of glomus tumours: a report of three cases. J Eur Acad Dermatol Venereol 2019; 33:e331-e334. [PMID: 30980764 DOI: 10.1111/jdv.15626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Rajabi-Estarabadi
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A E Eber
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - J Tsatalis
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - T Vazquez
- Florida International University Wertheim College of Medicine, Miami, FL, USA
| | - M Perper
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - K Nouri
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Abstract
Despite our understanding that the microvasculature plays a multifaceted role in the development and progression of various conditions, we know little about the extent of this involvement. A need exists for non-invasive, clinically meaningful imaging modalities capable of elucidating microvascular information to aid in our understanding of disease, and to aid in the diagnosis/monitoring of disease for more patient-specific care. In this review article, a number of imaging techniques are summarized that have been utilized to investigate the microvasculature of skin, along with their advantages, disadvantages and future perspectives in preclinical and clinical settings. These techniques include dermoscopy, capillaroscopy, Doppler sonography, laser Doppler flowmetry (LDF) and perfusion imaging, laser speckle contrast imaging (LSCI), optical coherence tomography (OCT), including its Doppler and dynamic variant and the more recently developed OCT angiography (OCTA), photoacoustic imaging, and spatial frequency domain imaging (SFDI). Attention is largely, but not exclusively, placed on optical imaging modalities that use intrinsic optical signals to contrast the microvasculature. We conclude that whilst each imaging modality has been successful in filling a particular niche, there is no one, all-encompassing modality without inherent flaws. Therefore, the future of cutaneous microvascular imaging may lie in utilizing a multi-modal approach that will counter the disadvantages of individual systems to synergistically augment our imaging capabilities.
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Affiliation(s)
- Anthony J Deegan
- Department of Bioengineering, University of Washington, 3720 15th Ave. NE., Seattle, WA 98195, United States of America
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21
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Olsen J, Birch-Johansen FH, Themstrup L, Holmes J, Jemec GBE. Dynamic optical coherence tomography of histamine induced wheals. Skin Res Technol 2018; 24:592-598. [DOI: 10.1111/srt.12470] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 01/08/2023]
Affiliation(s)
- J. Olsen
- Department of Dermatology; Zealand University Hospital; Roskilde Denmark
- Health Sciences Faculty; University of Copenhagen; Copenhagen Denmark
| | - F. H. Birch-Johansen
- Department of Dermatology; Zealand University Hospital; Roskilde Denmark
- Health Sciences Faculty; University of Copenhagen; Copenhagen Denmark
| | - L. Themstrup
- Department of Dermatology; Zealand University Hospital; Roskilde Denmark
- Health Sciences Faculty; University of Copenhagen; Copenhagen Denmark
| | - J. Holmes
- Michelson Diagnostics Ltd; Maidstone UK
| | - G. B. E. Jemec
- Department of Dermatology; Zealand University Hospital; Roskilde Denmark
- Health Sciences Faculty; University of Copenhagen; Copenhagen Denmark
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Olsen J, Holmes J, Jemec GB. Advances in optical coherence tomography in dermatology-a review. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-10. [PMID: 29701018 DOI: 10.1117/1.jbo.23.4.040901] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 03/26/2018] [Indexed: 05/24/2023]
Abstract
Optical coherence tomography (OCT) was introduced as an imaging system, but like ultrasonography, other measures, such as blood perfusion and polarization of light, have enabled the technology to approach clinical utility. This review aims at providing an overview of the advances in clinical research based on the improving technical aspects. OCT provides cross-sectional and en face images down to skin depths of 0.4 to 2.00 mm with optical resolution of 3 to 15 μm. Dynamic optical coherence tomography (D-OCT) enables the visualization of cutaneous microvasculature via detection of rapid changes in the interferometric signal of blood flow. Nonmelanoma skin cancer (NMSC) is the most comprehensively investigated topic, resulting in improved descriptions of morphological features and diagnostic criteria. A refined scoring system for diagnosing NMSC, taking findings from conventional and D-OCT into account, is warranted. OCT diagnosis of melanoma is hampered by the resolution and the optical properties of melanin. D-OCT may be of value in diseases characterized with dynamic changes in the vasculature of the skin and the addition of functional measures is strongly encouraged. In conclusion, OCT in dermatology is still an emerging technology that has great potential for improving further in the future.
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Affiliation(s)
| | - Jon Holmes
- Michelson Diagnostics Ltd., United Kingdom
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23
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Themstrup L, De Carvalho N, Nielsen SM, Olsen J, Ciardo S, Schuh S, Nørnberg BMH, Welzel J, Ulrich M, Pellacani G, Jemec GBE. In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography. Exp Dermatol 2018; 27:156-165. [DOI: 10.1111/exd.13479] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Lotte Themstrup
- Department of Dermatology; Zealand University Hospital; Roskilde Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | | | - Sabrina M. Nielsen
- Musculoskeletal Statistics Unit; The Parker Institute; Bispebjerg and Frederiksberg Hospital; Frederiksberg Copenhagen Denmark
| | - Jonas Olsen
- Department of Dermatology; Zealand University Hospital; Roskilde Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - Silvana Ciardo
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - Sandra Schuh
- Department of Dermatology and Allergology; General Hospital Augsburg; Augsburg Germany
| | | | - Julia Welzel
- Department of Dermatology and Allergology; General Hospital Augsburg; Augsburg Germany
| | | | - Giovanni Pellacani
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - Gregor B. E. Jemec
- Department of Dermatology; Zealand University Hospital; Roskilde Denmark
- Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
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