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Bertoli C, Chester J, Cortelazzi C, Ciardo S, Manfredini M, Di Nuzzo S, Kaleci S, Pellacani G, Farnetani F. Vitiligo Treated with Combined Piperine-Based Topical Treatment and Narrowband Ultraviolet B Therapy: Follow-Up with Reflectance Confocal Microscopy. Diagnostics (Basel) 2024; 14:494. [PMID: 38472966 DOI: 10.3390/diagnostics14050494] [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: 11/23/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Reflectance confocal microscopy (RCM) has a defined in vivo morphology of vitiligo and re-pigmentation. Combination therapies seem more effective than monotherapies. OBJECTIVE We aim to describe the clinical and RCM features of re-pigmentation with combined narrowband ultraviolet B (NB-UVB) and piperine-based topical treatment in localized vitiligo. METHODS Eight patients enrolled at a single center received combined treatment: topical treatment was applied twice daily + NB-UVB twice weekly for 2 × 2-month periods. Clinical changes were analyzed by the Vitiligo Noticeability Scale (VNS) and percentage of re-pigmentation. The evaluator agreement was assessed. Predefined RCM features had the presence/absence of (i) blood vessels, (ii) dendritic cells, and the quantity of (i) an irregular honeycombed pattern and (ii) non-pigmented papillae. Clinical and RCM monitoring was performed at the baseline, 2, 3, 5, and 7 months. RESULTS Macules were "slightly less noticeable" with 25-50% re-pigmentation. Irregular honeycomb patterns and non-pigmented papillae were significantly less frequently observed, and in less extended areas (T1 vs. T2, p = 0.039; T0 vs. T1, p = 0.005 and T2 vs. T4, p = 0.033). Dendritic cells and blood vessels improved, with significant changes in blood vessels (T1 vs. T2, p = 0.005 and T3 vs. T4, p = 0.008). CONCLUSIONS RCM confirms the morphological changes induced by combined treatment for localized vitiligo.
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Affiliation(s)
- Cristina Bertoli
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
| | - Johanna Chester
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
| | - Chiara Cortelazzi
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
| | - Silvana Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
| | - Marco Manfredini
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
| | - Sergio Di Nuzzo
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
| | - Shaniko Kaleci
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00196 Rome, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
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Wang Y, Chen L, Fang H, Li Q. Reflectance confocal microscopy clinical applications: Hypopigmented skin lesions in pediatric patients. Skin Res Technol 2024; 30:e13576. [PMID: 38213040 PMCID: PMC10784645 DOI: 10.1111/srt.13576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Affiliation(s)
- Ying Wang
- Department of DermatologyTianjin Children's Hospital/Tianjin University Children's HospitalTianjinChina
| | - Lixin Chen
- Department of DermatologyTianjin Children's Hospital/Tianjin University Children's HospitalTianjinChina
| | - Hongwei Fang
- Department of OtolaryngologyTianjin Children's Hospital/Tianjin University Children's HospitalTianjinChina
| | - Qinfeng Li
- Department of DermatologyTianjin Children's Hospital/Tianjin University Children's HospitalTianjinChina
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Fu Z, Zeng J, Zhu L, Wang G, Li P, Li W, Song Z, Su Z, Sun X, Tang H, Luo P, Tan L, Gao L, Wang D, Yan S, Zhou L, Tong X, Tang Z, Zhang H, Tan W, Lu J, Zhu S. Clinical factors associated with remission of obese acanthosis nigricans after laparoscopic sleeve gastrectomy: a prospective cohort study. Int J Surg 2023; 109:3944-3953. [PMID: 37678289 PMCID: PMC10720823 DOI: 10.1097/js9.0000000000000693] [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: 05/08/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Acanthosis nigricans (AN) involves skin hyperpigmentation in body folds and creases. Obesity-associated AN (OB_AN) is the most common type of AN. The skin condition of obese patients with AN can be improved through bariatric surgery, such as laparoscopic sleeve gastrectomy (LSG), after weight loss. However, the contributing factors to the remission of AN after surgery are still not fully determined. The authors aimed to assess the metabolic and pathological factors associated with remission of AN following LSG in obese individuals. METHODS The study included 319 obese patients who underwent LSG at our hospital. The subjects were divided into obesity (OB) only (OB, n =178) or OB with AN (OB_AN, n =141) groups. The basic clinical and metabolic indices and the dermatological features via reflectance confocal microscopy and histology were collected from patients prior to and after LSG. RESULTS OB_AN patients had higher fasting plasma glucose, homeostatic model assessment for insulin resistance, and testosterone levels than OB patients. LSG could significantly improve the biochemical and histopathological features of OB_AN patients. The remissive rate of OB_AN patients was about 86.5% (122 out of 141) after surgery. The remission of OB_AN skin lesions was positively correlated with testosterone levels ( P <0.01). In addition, there was a significant positive correlation between changes in AN scores and epidermal thickness and skin pigmentation scores after surgery ( P <0.01). CONCLUSION The remissive rate of OB_AN after LSG is associated with improved testosterone levels and reduced epidermal thickness and skin pigmentation levels.
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Affiliation(s)
- Zhibing Fu
- Department of General Surgery
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Jinrong Zeng
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | | | | | | | | | | | | | | | | | | | - Lina Tan
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Lihua Gao
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Dan Wang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Siyu Yan
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Lu Zhou
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Xiaoliao Tong
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Zhen Tang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Hanyi Zhang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Wenbin Tan
- Department of Cell Biology and Anatomy, School of Medicine
- Department of Biomedical Engineering, College of Engineering and Computing, University of South Carolina, Columbia, South Carolina, USA
| | - Jianyun Lu
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
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Ding Y, Xu Z, Xiang LF, Zhang C. Unveiling the mystery of Riehl's melanosis: An update from pathogenesis, diagnosis to treatment. Pigment Cell Melanoma Res 2023; 36:455-467. [PMID: 37401632 DOI: 10.1111/pcmr.13108] [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: 01/10/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
Riehl's melanosis is a hyperpigmentation disorder that has a significant psychological and social impact on individuals. In the past 10 years, new categories have been developed, raising questions about how to classify Riehl's melanosis. The mechanism of this disease remains unclear, although the type IV hypersensitivity response caused by allergic sensitization, as well as genetic, ultraviolet radiation, and autoimmune factors, is to blame. Clinical manifestation, dermoscopy, reflectance confocal microscopy, patch/photopatch testing, histopathology, and a novel multimodality skin imaging system have been used for the diagnosis. A variety of therapies including topical skin-lightening agents, oral tranexamic acid, glycyrrhizin compound, chemical peels, and lasers and light therapies (intense pulsed light, 1064-nm Q-Switched Nd: YAG laser, 755-nm PicoWay laser, nonablative 1927-nm fractional thulium fiber laser, new pulsed-type microneedling radiofrequency), with improved effectiveness. The latest findings on possible biomarkers and their relationship to other autoimmune diseases were also summarized.
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Affiliation(s)
- Yuecen Ding
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhongyi Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Leihong Flora Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chengfeng Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
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Takimoto B, Bito K, Hari S, Taguchi H, Haneishi H. Observation and density estimation of a large number of skin capillaries using wide-field portable video capillaroscopy and semantic segmentation. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:106003. [PMID: 37881371 PMCID: PMC10594543 DOI: 10.1117/1.jbo.28.10.106003] [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: 03/10/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
Significance Skin capillaries are non-invasively observable; their structure and blood flow can reflect tissue and systemic conditions. Quantitative analysis of video-capillaroscopy images yields novel diagnostic methods. Because the capillary structure is heterogeneous, analyzing more capillaries can increase the evaluation reliability. Aim We developed a system that can observe and quantify numerous capillaries and verified the performance on human skin. Approach We developed a portable video-capillaroscope with a spatial resolution higher than 3.5 μ m and a wide field of view (7.4 mm × 5.5 mm ) and a method to evaluate capillary numbers and areas using U-Net. The model was trained and tested with 22 and 11 cropped images (2.4 mm × 1.9 mm ) obtained from 11 participants, respectively. They were then applied to the 7.2 mm × 5.3 mm images from four participants. Segmentation results were compared to ground-truth at the pixel level and capillary-region level. Results Over 1000 capillaries were simultaneously observed using the proposed system. Although pixel-level segmentation performance was low [intersection over union (IoU) = 24.5%], the number and area could be estimated. These values differed among four participants and seven sites, and they changed after skin barrier destruction. Conclusions The proposed system allows for observing and quantifying numerous skin capillaries simultaneously, suggesting its potential for evaluating tissue and systemic conditions.
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Affiliation(s)
- Baku Takimoto
- Kao Corporation, Analytical Science Research Laboratories, Tokyo, Japan
| | - Kotatsu Bito
- Kao Corporation, Digital Business Creation, Corporate Strategy, Tokyo, Japan
| | - Sayaka Hari
- Kao Corporation, Health and Wellness Products Research Laboratories, Tokyo, Japan
| | | | - Hideaki Haneishi
- Chiba University, Center for Frontier Medical Engineering, Chiba, Japan
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Li Y, Wu M, Hu X, Chen G, Yao X, Zhou X, Lu J. The Role of Reflectance Confocal Microscopy in the Diagnosis and Therapeutic Evaluation of Rare Disease Eosinophilic Pustular Folliculitis. Clin Cosmet Investig Dermatol 2023; 16:2309-2314. [PMID: 37649569 PMCID: PMC10464821 DOI: 10.2147/ccid.s423973] [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: 06/21/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
Eosinophilic pustular folliculitis (EPF) is a rare skin disease for which the gold standard of diagnosis relies on the invasive examination of pathological tissue sections. However, due to its invasive nature, many patients tend to refuse this diagnostic test. In such situations, reflectance confocal microscopy (RCM) can be a valuable diagnosis tool. Reflectance confocal microscopy (RCM) can accurately identify the specific structures for biopsy and provide objective imaging data to evaluate clinical symptoms following treatment. Therefore, we present a case report demonstrating the utility of RCM in diagnosing and assessing the treatment of the rare disease EPF for reference.
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Affiliation(s)
- Yuan Li
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Miaoting Wu
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Xiaohuan Hu
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Gaihe Chen
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Xiaojuan Yao
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Xin Zhou
- Medical Administration Department, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Jiejie Lu
- Department of Cosmetic Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
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Jiang Q, Chen H, Chen K, Xia P, Chen J, Su F, Huang M, Xia Y, Hu F, Chen L. Reflectance confocal microscopy for non-invasive diagnosis of childhood-onset vulvar lichen sclerosus: A retrospective study. J Eur Acad Dermatol Venereol 2023; 37:e303-e305. [PMID: 36433788 DOI: 10.1111/jdv.18786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 11/22/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Qian Jiang
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - Hongying Chen
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - Kai Chen
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - Ping Xia
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - Jinbo Chen
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - Fei Su
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - Meng Huang
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - Yun Xia
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - Feng Hu
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - Liuqing Chen
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
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Gu AK, Shi J, Zhang XJ, Ma FK, Zhang Y. Assessment of diagnostic accuracy of confocal image features used in detection of hypopigmented verruca plana on children's forehead and classic verruca plana in adult. Skin Res Technol 2022; 28:491-493. [PMID: 35416348 PMCID: PMC9907583 DOI: 10.1111/srt.13148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 11/30/2022]
Affiliation(s)
- An-Kang Gu
- Department of Pathology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Jing Shi
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Xiu-Jun Zhang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Fa-Ku Ma
- Department of Pathology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Yu Zhang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
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