Confocal laser microscopic imaging of actinic keratoses in vivo: A preliminary report

Confocal Laser Scanning Microscopy as a Tool for the Investigation of Skin Drug Delivery Systems and Diagnosis of Skin Disorders

“…The clinical diagnosis of actinic keratosis by CRM (Figure 14) was first determined by Aghassi et al (2000) [78]. Later, others confirmed the usefulness of this tool [73,[88][89], although it has not been able to unequivocally differentiate actinic keratosis from squamous cell carcinomas [90].…”

“…In dermatology, CRM has several uses, such as: i) to diagnose diseases non-invasively in vivo [69][70][71][72]; ii) to non-invasive monitoring of treatment response in vivo and permits early detection of subclinical disease [73]; iii) to improve the accuracy of clinical diagnosis [74]; iv) to improve clinical discrimination between benign and malignant lesions [75]; v) to evaluate the same skin site over time because it produces no tissue damage [76]; vi) to assess the boundaries of the lesion pre-or post-surgery [54]; vii) to evaluate the dynamics of structural and cellular changes that take place during the occurrence of the disease [77]; and viii) to study physiopathologic processes non-invasively over time [78][79].…”

“…CRM imaging elucidates and monitors the dynamic pathophysiologic response, such as those that occur subsequent to laser treatment of cutaneous lesions, like cherry angiomas [78] and sebaceous gland hyperplasia [100][101]. Moreover, it facilitates the discrimination of sebaceous hyperplasia from basal cell carcinoma in vivo [102].…”

Using optical coherence tomography to evaluate skin sun damage and precancer

“…However, it is unlikely that the resolution would be high enough to visualize cell nuclei and connective tissue bundles, which are the features examined for diagnosis of AK and grading of sun damage in gold standard histology. Achieving high resolution may be difficult based on the experiences of reflectance confocal microscopy, where imaging of AK was often compromised by the thick hyperkeratotic layers [15].…”

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“…CLSM, a non-invasive diagnostic tool, was first reported in 1995 to be used in vivo on human tissue [8]. Since then, there has been many studies evaluating its role in viewing the microscopic features of normal skin [9] and various lesions such as cutaneous neoplasms [10,11], pigmented lesions [12,13,14], actinic keratosis [15], sebaceous gland hyperplasia [16], psoriasis [17], irritant and allergic contact dermatitis [18,19]. CLSM can distinguish melanocytes from other pigmented lesions like pigmented J Cancer Res Therap Oncol 2015 | Vol 3: 104 keratinocytes and melanophages [20].…”