In vivoconfocal microscopy efficacy assessment of daylight photodynamic therapy in actinic keratosis patients

Abstract

RCM features of actinic damage at cellular level have been shown to correlate well with the results of a clinical assessment of AK lesions. This study confirms that in vivo RCM technology might be an additional technique to monitor the efficacy of DL-PDT for AK.

In vivo Confocal Laser Microscopy for monitoring of actinic keratosis treatment: a comparison with histopathologic assessment after treatment with topical 5% 5‐fluorouracil

“…foci of atypical honeycomb areas were observed in our study characterized by the presence of keratinocytes of different sizes and shapes, unclear intercellular borders and nuclear atypia. Seyed Jafari et al . also verified that 40% of treated AK lesions present atypical honeycomb and cellular atypia in at least 10% of the analysed area.…”

“…A RCM monitoring study was also performed by Maier et al ., which assessed AK treatment with mebutate ingenol and emphasized that RCM is superior to clinical examination in the detection of lesions that are not responsive to treatment or are only partially treated . Seyed Jafari et al . also emphasized the importance of RCM in therapeutic evaluation of AKs undergoing photodynamic therapy.…”

Confocal Microscopy and Lentigo Maligna: An in vivo Pilot Study for the Assessment of Response to Imiquimod Therapy

“…In recent years, in vivo confocal microscopy has gained increasing significance as a new method of painless and noninvasive examination of cutaneous tumors at high magnification [6, 17]. The current study evaluated RCM as an alternative to histology in the diagnosis of LM and efficacy assessment of therapy with imiquimod for LM.…”

“…Although the histological examination is still the gold standard to confirm the diagnosis of LM, this method is time consuming, invasive and painful, especially at cosmetic critical locations in the face or at the head [4-6]. Histologic features associated with chronic sun-damaged skin of LM patients are epidermal atrophy, increased pigmentation in basal keratinocytes, and prominent solar elastosis [7].…”

“…The limitations of histological examination have led to the development of new noninvasive diagnostic methods that offer real-time in vivo results without scarring [5, 6]. Among these techniques, in vivo reflectance confocal microscopy (RCM) which has been actively developing in recent years, with a sensitivity of 85% and specificity of 76% for the diagnosis of LM, allows real-time visualization of the skin up to a depth of 200 µm with the best imaging-histologic correlation [6, 8]. …”