Discrimination of Actinic Keratoses from Normal Skin with Reflectance Mode Confocal Microscopy

Horn, Michael; Gerger, Armin; Ahlgrimm‐Siess, Verena; Weger, Wolfgang; Koller, Sílvia Helena; Kerl, Helmut; Samonigg, Hellmut; Smolle, Josef; Hofmann‐Wellenhof, Rainer

doi:10.1111/j.1524-4725.2008.34195.x

Cited by 60 publications

(63 citation statements)

References 23 publications

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“…Similarly, 4–6 individual RCM images were captured in each epidermal layer, following a standardized evaluation protocol and individually subjected to descriptive analysis during the evaluation process. Based on previously defined RCM criteria, specific study sites were evaluated for the presence or absence of RCM features of AK [25,26,27]. The presence of main features was indicative of AK: disruption of the stratum corneum, individual corneocytes, parakeratosis/hyperkeratosis, overall architectural disruption, nuclear atypia/cellular pleomorphism at the level of the basal, spinous and granular layer.…”

Section: Methodsmentioning

confidence: 99%

“…A single image allows in vivo evaluation of a 500 × 500 µm area and by scanning of the microscope composite images, up to 8 × 8 mm can be obtained. RCM has been used for the evaluation of a variety of inflammatory and neoplastic skin disorders [19,20,21,22,23,24]; recently, the clinically applicability of this method for the evaluation of AK has been investigated [25,26,27]. It was postulated that initial changes of epidermal morphology and cellular atypia may be visualized by RCM before becoming clinically apparent.…”

Section: Introductionmentioning

confidence: 99%

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Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

et al. 2009

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Background: Actinic keratoses (AK) represent cutaneous carcinoma in situ and have previously been evaluated by reflectance confocal microscopy (RCM). Treatment of AK with imiquimod (IMIQ) 5% cream has been shown to ‘highlight’ subclinical lesions. Objective: The aim of this study was to test the applicability of RCM for noninvasive monitoring of actinic field cancerization and detection of subclinical AK. Subjects and Methods: AK and surrounding skin sites with no apparent AK of 11 volunteers were selected for imaging and subsequently classified as ‘clinical’ and ‘subclinical’ AK. IMIQ was used 3 times weekly for 4 weeks. Results: RCM was able to detect morphologic features of AK in both clinical and subclinical AK; features were more pronounced in clinical lesions. The immunomodulatory response induced by IMIQ was visualized by RCM. Conclusion: Our findings indicate that RCM allows noninvasive monitoring of treatment response in vivo and permits early detection of subclinical AK, thus substantiating the incentive for therapy.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

et al. 2009

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“…Sie lassen sich auch in der CLSM in der Regel gut erkennen, sofern sie am Unterrand der Epidermis oder in (stellenweise) schlecht abgrenzbar [20] (Abbildung 8). …”

Section: Basalzellkarzinomunclassified

Diagnostik von Hauttumoren mittels in vivo konfokaler Laser‐Scanning‐Mikroskopie

Eichert

Möhrle

Breuninger

et al. 2010

J Deutsche Derma Gesell

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SummaryIn recent years, in vivo confocal laser scanning microscopy (CLSM) has become an established method for the non-invasive examination of the skin. In vivo CLSM allows for real-time imaging of micro-anatomic cutaneous structures. It has been used to diagnose ambiguous skin tumors and to measure subclinical tumor spread prior to surgery. By additionally providing high power morphologic information, in vivo CLSM helps to reduce unnecessary biopsies. A multitude of diagnostic features for skin tumors has been published. Here we review published diagnostic in vivo CLSM features, and compare them to our own experience in 100 tumors. In combination with clinical examination and dermatoscopy, in vivo CLSM is a valuable additional tool for non-invasive skin tumor diagnosis.

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“…The characteristics of R-CSLM images of precancerous lesions, such as actinic keratosis were described. 25,26 Despite wide use of imaging techniques in diagnosing hair diseases, R-CSLM is currently not being used in trichology. By some authors, presence of hairs in an R-CSLM image is even considered an artifact.…”

Section: Introductionmentioning

confidence: 99%

In vivo reflectance confocal microscopy: usefulness for diagnosing hair diseases

Rudnicka¹,

Olszewska²,

Rakowska³

2008

J Dermatol Case Rep

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Background: Reflectance confocal laser scanning microscopy (R-CSLM) is a new diagnostic technique which allows visualization of "optical intersections" within the epidermis and superficial layers of the dermis. Outlines of cells and their architecture are imaged and may be analyzed both horizontally and vertically to the skin surface. The method proved useful in early melanoma detection. We evaluated the potential usefulness of this method in a short series of patients with hair diseases.Main observations: Two healthy persons and 6 patients with hair diseases (1 with alopecia areata, 1 with androgenic alopecia and 4 with genetic hair shaft abnormalities) were examined with the use of Vivascope 1500. In all patients one scalp location and one location in the mid forearm were evaluated. R-CSLM examination gave in all cases high quality images of the hair shaft intersections, at 1μm intervals, which allowed detailed analysis of the hair structure. Hair follicles could be partly visualized at a depth of up to 200μm, which allowed analysis of only superficial parts of the hair follicles. An additional hurdle was bright reflection within the follicular ostia, which decreased the perception of details in these images.Hair could be best visualized, when analyzed on flat surfaces. Receiving good quality images from convex surfaces on the scalp required additional effort from the patient (to not move) and from the physician (to obtain best possible fit of the "optic window" to the scalp).Conclusions: These preliminary data show that R-CSLM may develop into a valuable tool in evaluation of hair shaft diseases. Further development is needed to apply this technique in abnormalities of the hair follicle and the perifollicular area.

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Discrimination of Actinic Keratoses from Normal Skin with Reflectance Mode Confocal Microscopy

Abstract: This study provides a set of morphologic confocal microscopy criteria showing promise as a noninvasive monitoring tool in the treatment of actinic keratoses.

Cited by 60 publications

References 23 publications

Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

Diagnostik von Hauttumoren mittels in vivo konfokaler Laser‐Scanning‐Mikroskopie

In vivo reflectance confocal microscopy: usefulness for diagnosing hair diseases

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