A standard picture of healthy oral mucosae by direct oral microscopy

Clinicodermoscopic study of histoid leprosy: a case series

BACKGROUND

Histoid leprosy (HL) is a highly bacilliferous form of leprosy which requires early diagnosis and management. Dermoscopy is a noninvasive diagnostic method for various malignant and nonmalignant disorders. The aim of this study was to describe the dermoscopic patterns of various types of HL lesions over different body parts.

METHODS

This was a hospital-based observational study which evaluated the clinical and dermoscopic features of a series of patients with the diagnosis of HL. The diagnosis was confirmed clinically, histologically, and through the demonstration of bacilli. A handheld dermatoscope at 10x magnification in polarized mode was employed to examine multiple lesions over various body sites.

RESULTS

A total of four patients (three female, one male) were included. Papules were the most common type of lesion, and limbs were most frequently involved. Linear branching vessels and shiny white structures were present in all cases and in all lesion types. The linear branching vessels frequently presented in the form of crown vessels. Ulcerated lesions and umbilicated lesions also showed prominent vascularity. Follicular plugging was observed in the lesions over limbs.

CONCLUSION

Dermoscopy may aid in the diagnosis of HL by showing prominent dermoscopic features such as linear branching vessels and shiny white structures.

In-vivo longitudinal imaging of microvascular changes in irradiated oral mucosa of radiotherapy cancer patients using optical coherence tomography

Mucositis is the limiting toxicity of radio(chemo)therapy of head and neck cancer. Diagnostics, prophylaxis and correction of this condition demand new accurate and objective approaches. Here we report on an in vivo longitudinal monitoring of the oral mucosa dynamics in 25 patients during the course of radiotherapy of oropharyngeal and nasopharyngeal cancer using multifunctional optical coherence tomography (OCT). A spectral domain OCT system with a specially-designed oral imaging probe was used. Microvasculature visualization was based on temporal speckle variations of the full complex signal evaluated by high-pass filtering of 3D data along the slow scan axis. Angiographic image quantification demonstrated an increase of the vascular density and total length of capillary-like-vessels before visual signs or clinical symptoms of mucositis occur. Especially significant microvascular changes compared to their initial levels occurred when grade two and three mucositis developed. Further, microvascular reaction was seen to be dose-level dependent. OCT monitoring in radiotherapy offers a non-invasive, convenient, label-free quantifiable structural and functional volumetric imaging method suitable for longitudinal human patient studies, furnishing fundamental radiobiological insights and potentially providing useful feedback data to enable adaptive radiotherapy (ART).