The skin through reflectance confocal microscopy — Historical background, technical principles, and its correlation with histopathology

Fraga‐Braghiroli, Naiara; Sugerik, Samantha; Freitas, Luiz Antônio Rodrigues de; Oliviero, Margaret; Rabinovitz, Harold

doi:10.1016/j.abd.2021.10.010

Cited by 9 publications

(12 citation statements)

References 21 publications

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“…These results indicate that severe barrier defects are restricted to the face in patients with rosacea. A literature of RCM reported that the granular layer was approximately 15–20 μm in depth 4 . Similarly, our results revealed that the TJ located in the granular layer was considered to be approximately 16–24 μm in depth.…”

Section: Discussionsupporting

confidence: 83%

“…A literature of RCM reported that the granular layer was approximately 15-20 μm in depth. 4 Similarly, our results revealed that the TJ located in the granular layer was considered to be approximately 16-24 μm in depth. At this level, the zinc reflectance of the AD group was higher than that of the rosacea and normal groups (Figure 1).…”

Section: Con Clus I On S and Per S Pec Tive Ssupporting

confidence: 70%

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Zinc penetration through the skin barrier in atopic dermatitis and rosacea using reflectance confocal microscopy

Ahn,

Shin

2023

Experimental Dermatology

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Atopic dermatitis (AD) is a chronic, recurrent eczematous disorder with a complex pathophysiology caused by skin barrier abnormalities. Rosacea is a common chronic immune‐mediated inflammatory disorder that results in diminished skin barrier function. Reflectance confocal microscopy (RCM) is a non‐invasive method for visualizing the dynamic status of epidermal and upper dermal structures. In this study, we compared skin barrier permeability among normal, AD and rosacea groups. To assess skin barrier permeability, zinc was applied to lesional skin and the RCM reflectance intensity of zinc penetration was measured. Reflectance confocal microscopy revealed that the intensity in patients with rosacea and AD was higher than that in the normal group at depths of 8–24 μm in both the face and forearm, which were considered as the stratum corneum (SC) and tight junction (TJ) level (p < 0.0001). When comparing AD and rosacea, the intensity of rosacea was higher than that of AD at a depth of 8 μm in the face (p < 0.0001). The intensity of AD was higher than that of rosacea at a depth of 24 μm (p = 0.009). This suggests that skin barrier permeability is increased in the upper epidermis of patients with AD and rosacea. On the face, patients with rosacea had more SC weakness than did those with AD, whereas patients with AD had more TJ weakness than those with rosacea.

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Section: Discussionsupporting

confidence: 83%

Section: Con Clus I On S and Per S Pec Tive Ssupporting

confidence: 70%

Zinc penetration through the skin barrier in atopic dermatitis and rosacea using reflectance confocal microscopy

Ahn,

Shin

2023

Experimental Dermatology

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“…RCM is widely used for its fast imaging, large field of view and ability to visualise blood vessels. However, it has lower resolution compared with MPM and cannot distinguish between cell nuclei and cytoplasm 53 . On the other hand, MPM leverages two‐photon properties to assess cellular metabolism by fluorescence signals and identify collagen and elastic fibres.…”

Section: Comparison With Other Non‐invasive Examinationsmentioning

confidence: 99%

Submicron resolution techniques: Multiphoton microscopy in skin disease

Chen

Han

Wang

et al. 2023

Experimental Dermatology

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Non‐invasive optical examination plays a crucial role in various aspects of dermatology, such as diagnosis, management and research. Multiphoton microscopy uses a unique submicron technology to stimulate autofluorescence (AF), allowing for the observation of cellular structure, assessment of redox status and quantification of collagen fibres. This advanced imaging technique offers dermatologists novel insights into the skin's structure, positioning it as a promising ‘stethoscope’ for future development in the field. This review provides an overview of multiphoton microscopy's principles, technology and application in studying normal skin, tumour and inflammatory diseases, as well as collagen‐related and pigmentary diseases.

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“…Reflectance confocal microscopy (RCM) is another method for high‐resolution skin imaging for diagnostic purposes. RCM also uses confocal illumination to display high‐resolution images based on changes in the refractive index of tissue, but its penetration depth is limited to approximately 200–250 μm 28 …”

Section: Introductionmentioning

confidence: 99%

“…RCM also uses confocal illumination to display high-resolution images based on changes in the refractive index of tissue, but its penetration depth is limited to approximately 200-250 μm. 28 Melanin has a high absorption in both broad spectrum visible light and near-infrared light bands. 29 Based on light-tissue interaction theories, pleomorphic malignant cells are altered biological tissue and thus will have differences in refractive index and absorptive properties compared to normal cells.…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography confirms non‐malignant pigmented lesions in phacomatosis pigmentokeratotica using a support vector machine learning algorithm

Lee

Beirami

Ebrahimpour

et al. 2023

Skin Research and Technology

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Introduction:Phacomatosis pigmentokeratotica (PPK), an epidermal nevus syndrome, is characterized by the coexistence of nevus spilus and nevus sebaceus. Within the nevus spilus, an extensive range of atypical nevi of different morphologies may manifest. Pigmented lesions may fulfill the ABCDE criteria for melanoma, which may prompt a physician to perform a full-thickness biopsy.Motivation: Excisions result in pain, mental distress, and physical disfigurement. For patients with a significant number of nevi with morphologic atypia, it may not be physically feasible to biopsy a large number of lesions. Optical coherence tomography (OCT) is a non-invasive imaging modality that may be used to visualize non-melanoma and melanoma skin cancers. Materials and Method:In this study, we used OCT to image pigmented lesions with morphologic atypia in a patient with PPK and assessed their quantitative optical properties compared to OCT cases of melanoma. We implement a support vector machine learning algorithm with Gabor wavelet transformation algorithm during post-image processing to extract optical properties and calculate attenuation coefficients. Results:The algorithm was trained and tested to extract and classify textural data. Conclusion:We conclude that implementing this post-imaging machine learning algorithm to OCT images of pigmented lesions in PPK has been able to successfully confirm benign optical properties. Additionally, we identified remarkable differences in attenuation coefficient values and tissue optical characteristics, further defining separating benign features of pigmented lesions in PPK from malignant features.

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The skin through reflectance confocal microscopy — Historical background, technical principles, and its correlation with histopathology

Cited by 9 publications

References 21 publications

Zinc penetration through the skin barrier in atopic dermatitis and rosacea using reflectance confocal microscopy

Zinc penetration through the skin barrier in atopic dermatitis and rosacea using reflectance confocal microscopy

Submicron resolution techniques: Multiphoton microscopy in skin disease

Optical coherence tomography confirms non‐malignant pigmented lesions in phacomatosis pigmentokeratotica using a support vector machine learning algorithm

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