Dynamic skin changes of acute radiation dermatitis revealed by in vivo reflectance confocal microscopy

Abstract

RCM may safely detect the dynamic biological changes that the skin undergoes in response to ionizing radiation, even before than clinical onset of acute radiation dermatitis. Therefore, RCM may be useful to make an early and non-invasive diagnosis of radiation dermatitis during radiotherapy, allowing an early selection of patients needing treatment or close monitoring and avoiding skin biopsies.

Assessment of changes in lentigo maligna during radiotherapy byin-vivoreflectance confocal microscopy: a pilot study

“…Due to inflammation, dilated vessels appeared in all patients and were visible by dermoscopy as well as RCM. Epidermal and upper dermal changes in acute radiation dermatitis were investigated by RCM in breast cancer patients by Vano‐Galvan et al . They could observe the initial appearance of spongiosis, exocytosis and appearance of inflammatory cells in the dermis during radiotherapy followed by the appearance of dendritic cells in most of the patients .…”

“…Lentigo maligna nonspecific RCM criteria: melanophages in the upper dermis, solar elastosis, superficial necrosis, inflammatory cells in both localizations: epidermis and dermis, apoptotic cells, dilated vessels and dendritic cells …”

“…5 Lentigo maligna nonspecific RCM criteria: melanophages in the upper dermis, solar elastosis, superficial necrosis, inflammatory cells in both localizations: epidermis and dermis, apoptotic cells, dilated vessels and dendritic cells. 5,[27][28][29][30][31][32][33] For diagnostic assessment three observers with experience in clinical, dermoscopic and RCM diagnosis blinded for the stage of treatment assessed the RCM images of each lesion and documented the findings by consensus.…”

The value ofin vivoreflectance confocal microscopy in the diagnosis and monitoring of inflammatory and infectious skin diseases: a systematic review

“…The majority of the included studies were categorized as papulosquamous and eczematous diagnoses: psoriasis, 8,9,11,18,[20][21][22][23][24][25][26][27][28][29][30] pityriasis rubra pilaris, 31 lichen planus 32 and lichen nitidus, 33 radiation dermatitis, 34 allergic and contact dermatitis. 8,[35][36][37][38][39][40][41][42][43][44] Cutaneous T-cell lymphoma (mycosis fungoides, parapsoriasis en petite plaque, lymphomatoid papulosis, S ezary syndrome) 8,[45][46][47][48][49] and bullous diseases (pemphigus foliaceus, pemphigus vulgaris, bullous pemphigoid, Hailey-Hai-ley, Darier-White) 9,18,[50][51][52][53][54][55] have been examined as well by RCM.…”

Radiation therapy for synchronous basal cell carcinoma and lentigo maligna of the nose: Response assessment by clinical examination and reflectance confocal microscopy

“…Observed changes in LMs after radiation include superficial necrosis and apoptotic cells, dilated vessels, and increased inflammatory cells in both the dermis and epidermis [8]. When using RCM to monitor for recurrence post-treatment, it is important to wait long enough to ensure any acute radiation-induced changes in skin architecture have resolved and will not cause false positives [9]. The ability to visualize and define changes during and after RT suggest RCM may be useful for monitoring for treatment failure.…”