Reflectance Confocal Microscopy in Evaluating Skin Cancer: A Clinicians's Perspective

Skin pore imaging using spectral-domain optical coherence tomography: a case report

Sebum is an important component of the skin that has attracted attention in many fields, including dermatology and cosmetics. Pore expansion due to sebum on the skin can lead to various problems. Therefore, it is necessary to analyze the morphological characteristics of sebum. In this study, we used optical coherence tomography (OCT) to evaluate facial sebum areas. We obtained the OCT maximum amplitude projection (MAP) image and a cross-sectional image of skin pores in the facial area. Subsequently, we detected the sebum in skin pores using the detection algorithm of the ImageJ software to quantitatively determine the size of randomly selected pores in the proposed MAP images. Additionally, the pore size was analyzed by acquiring images before and after facial sebum extraction. According to our research, facial sebum can be morphologically described using the OCT system. Since OCT imaging enables specific analysis of skin parameters, including pores and sebum, skin analysis employing OCT could be an effective method for further research.

Melanoma: How and When to Consider Clinical Diagnostic Technologies

In response to rising rates of melanoma worldwide, novel non-invasive melanoma detection techniques are emerging to facilitate the early detection of melanoma and decrease unnecessary biopsies of benign pigmented lesions. Because they often report similar study findings, it may be difficult to determine how best to incorporate these technologies into clinical practice based on their supporting studies alone. As an expansion of the recent article by Fried et al.¹, which reviewed the clinical data supporting these non-invasive melanoma detection techniques, the first article in this continuing medical education series provides practical advice on how and when to use various non-invasive melanoma detection techniques into clinical practice.

Technical Note: Noninvasive mid-IR fiber-optic evanescent wave spectroscopy (FEWS) for early detection of skin cancers

PURPOSE

Melanoma is the most lethal of the three primary skin cancers, including also basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), which are less lethal. The accepted diagnosis process involves manually observing a suspicious lesion through a Dermascope (i.e., a magnifying glass), followed by a biopsy. This process relies on the skill and the experience of a dermatologist. However, to the best of our knowledge, there is no accepted automatic, noninvasive, and rapid method for the early detection of the three types of skin cancer, distinguishing between them and noncancerous lesions, and identifying each of them. It is our aim to develop such a system.

METHODS

We developed a fiber-optic evanescent wave spectroscopy (FEWS) system based on middle infrared (mid-IR) transmitting AgClBr fibers and a Fourier-transform infrared spectrometer (FTIR). We used the system to perform mid-IR spectral measurements on suspicious lesions in 90 patients, before biopsy, in situ, and in real time. The lesions were then biopsied and sent for pathology. The spectra were analyzed and the differences between pathological and healthy tissues were found and correlated.

RESULTS

Five of the lesions measured were identified as melanomas, seven as BCC, and three as SCC. Using mathematical analyses of the spectra of these lesions we were able to tell that all were skin cancers and we found specific and easily identifiable differences between them.

CONCLUSIONS

This FEWS method lends itself to rapid, automatic and noninvasive early detection and characterization of skin cancers. It will be easily implemented in community clinics and has the potential to greatly simplify the diagnosis process.