1. Articles in category: Dermatology

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    1. Pigmented Lesions: Biopsy Methods and Emerging Non-invasive Imaging Techniques (Book Chapter)

      Pigmented Lesions: Biopsy Methods and Emerging Non-invasive Imaging Techniques (Book Chapter)

      Melanoma incidence has been increasing in the US population, with early detection and treatment leading to decreased morbidity and mortality. The first steps in diagnosis are clinical examination and skin biopsy. Various methods of skin biopsy exist and the appropriate choice can be challenging. In this chapter, we review various biopsy techniques including excisional, scoop (saucerization), incisional or punch, shave, biopsy of special sites, and emerging noninvasive imaging techniques for pigmented lesions including reflectance confocal microscopy, optical coherence tomography, digital multispectral dermoscopy, and tape stripping mRNA.

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    2. Mechanical spectroscopy and imaging of skin components in vivo: Assignment of the observed moduli

      Mechanical spectroscopy and imaging of skin components in vivo: Assignment of the observed moduli

      Background The need to quantitatively identify the composition and organization of the macromolecular components of skin, skin lesions, scars, tumors, extracellular matrices (ECMs), and wound tissue has been a goal of researchers for many decades. A variety of studies have been recently reported applying optical coherence tomography (OCT) to image skin and cutaneous lesions. Materials and Methods This article describes the use of vibrational OCT to image and noninvasively characterize the macromolecular components of the ECM of skin. Results We report that the major macromolecular components of skin and scar can be identified noninvasively by their characteristic moduli calculated from ...

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    3. OCT‐based angiography of human dermal microvascular reactions to local stimuli: Implications for increasing capillary blood collection volumes

      OCT‐based angiography of human dermal microvascular reactions to local stimuli: Implications for increasing capillary blood collection volumes

      Objectives To measure and compare microvascular responses within the skin of the upper arm to local stimuli, such as heating or rubbing, through the use of optical coherence tomography angiography (OCTA), and to investigate its impact on blood volume collection. Materials and Methods With the use of heat packs or rubbing, local stimulation was applied to the skin of either the left or right upper arm. Data from the stimulated sites were obtained using OCTA comparing pre‐ and post‐stimulation microvascular parameters, such as vessel density, mean vessel diameter, and mean avascular pore size. Additionally, blood was collected using a ...

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    4. Multiscale skin imaging in vivo using optical coherence tomography

      Multiscale skin imaging in vivo using optical coherence tomography

      Optical coherence tomography (OCT) is a noninvasive high-resolution diagnostic imaging modality that plays an increasingly important role in dermatology. Diagnosis of skin diseases using OCT requires both cellular-level high resolution and large area skin coverage. In practice, however, there exists a trade-off between the achievable spatial resolutions and the transverse scanning range. In this study, we report a Micro-OCT ( μ OCT) system that is capable of providing three-dimensional images of the skin at multiple spatial scales with both cellular-level resolution (1–2 μ m) mode and large area (~ mm 2 ) scanning mode. Specifically, in the cellular-level scanning mode, we achieve a transverse ...

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    5. Imaging of human finger nail-fold with MHz A-scan rate swept source optical coherence tomography

      Imaging of human finger nail-fold with MHz A-scan rate swept source optical coherence tomography

      We present a non-invasive three-dimensional depth-resolved micro-structure and micro-vasculature imaging of a human fingernail-fold with a swept-source optical coherence tomography (ssOCT) system at a 1064 nm center wavelength. A phase variance OCT angiography (OCTA) method was implemented for motion contrast OCT imaging. A Fourier-domain mode-locked light source with an A-scan rate of 1.7 MHz (1 700 000 A-scans s −1 ) was utilized for imaging. The experimental setup demonstrates OCT and OCTA imaging with an area of ~5 mm   ×   5 mm (within the Nyquist limit). Details of the ssOCTA system such as system parameters, scanning protocols, acquisition time, challenges, and ...

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      Mentions: Raju Poddar
    6. Pseudo‐Kaposi sarcoma: report of a case investigated by dermoscopy, reflectance confocal microscopy and optical coherence tomography

      Pseudo‐Kaposi sarcoma: report of a case investigated by dermoscopy, reflectance confocal microscopy and optical coherence tomography

      Letter to the editor. First described in 1965 by Mali et al., pseudo‐Kaposi sarcoma (PKS), also known as acroangiodermatitis, is a rare disease inscribed in the setting of cutaneous reactive angiomatoses (CRAs). CRA are all characterized by occlusion and/or inflammation of cutaneous vessels, followed by histiocyte recruitment and endotheliocyte and pericyte hyperplasia. As the name suggests, PKS nearly resembles Kaposi sarcoma, but is benign in its nature. PKS typically presents with violaceous papules and plaques, usually located on the inferior limbs.

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    7. Dynamic optical coherence tomography of histamine induced wheals

      Dynamic optical coherence tomography of histamine induced wheals

      Background Dynamic optical coherence tomography (D‐OCT) is a noninvasive imaging technique providing images of the skin and detecting movement in the tissue ie, measuring blood flow. The “attenuation coefficient” describes light absorption and scattering abilities of the tissue, while the dynamic signal provides a quantitative measure of the blood flow. Aim The study objective is to describe the dynamic changes of the skin and skin vessels during histamine release using D‐OCT. Methods Healthy volunteers had local histamine injections in the skin and D‐OCT‐scans performed at 2‐minute intervals to detect changes in blood flow, attenuation and ...

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    8. Advances in optical coherence tomography in dermatology—a review

      Advances in optical coherence tomography in dermatology—a review

      Optical coherence tomography (OCT) was introduced as an imaging system, but like ultrasonography, other measures, such as blood perfusion and polarization of light, have enabled the technology to approach clinical utility. This review aims at providing an overview of the advances in clinical research based on the improving technical aspects. OCT provides cross-sectional and en face images down to skin depths of 0.4 to 2.00 mm with optical resolution of 3 to 15  μm. Dynamic optical coherence tomography (D-OCT) enables the visualization of cutaneous microvasculature via detection of rapid changes in the interferometric signal of blood flow. Nonmelanoma ...

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    9. Sub-clinical assessment of atopic dermatitis severity using angiographic optical coherence tomography

      Sub-clinical assessment of atopic dermatitis severity using angiographic optical coherence tomography

      Measurement of sub-clinical atopic dermatitis (AD) is important for determining how long therapies should be continued after clinical clearance of visible AD lesions. An important biomarker of subclinical AD is epidermal hypertrophy, the structural measures of which often make optical coherence tomography (OCT) challenging due to the lack of a clearly delineated dermal-epidermal junction in AD patients. Alternatively, angiographic OCT measurements of vascular depth and morphology may represent a robust biomarker for quantifying the severity of clinical and sub clinical AD. To investigate this, angiographic data sets were acquired from 32 patients with a range of AD severities. Deeper vascular ...

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    10. Low-Coherence Reflectometry and Speckle Polarimetry in the Monitoring of Human Skin Pathologic Changes

      Low-Coherence Reflectometry and Speckle Polarimetry in the Monitoring of Human Skin Pathologic Changes

      We present the results of the study of normal and pathologic human skin using low-coherence reflectometry and speckle polarimetry. The statistical characteristics of local polarisation states in the individual coherence areas (speckles) of the forward scattered laser radiation demonstrate high sensitivity to the pathologic changes of the biotissue morphology in vitro. The analysis of the attenuation rate of the low-coherence reflectometer signal depending on the probing depth provides additional information for the identification of skin morphologic changes and the analysis of the effect of immersion agents on the biotissue optical properties.

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    11. Visualization of viscoelastic behavior in vivo skin using optical coherence tomography-based straingraphy combined with suction device

      Visualization of viscoelastic behavior in vivo skin using optical coherence tomography-based straingraphy combined with suction device

      Although various apparatuses have been developed to assess the skin mechanical function, the spatial viscoelastic behavior of each skin layer including the epidermis and dermis is yet unclear. To resolve that lack of clarity, we built a handmade system combining a suction device with optical coherence tomography (OCT). OCT can visualize the vertical section of the skin with high spatial resolution and high acquisition speed. In addition, we developed an algorithm for time-dependent strain tomography, named Dynamic Optical Coherence Straingraphy (D-OCSA), which can analyze the changes in strain distributions over time in sequential OCT images. Using the system, successive OCT ...

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    12. Ultrasound and Infrared-Based Imaging Modalities for Diagnosis and Management of Cutaneous Diseases

      Ultrasound and Infrared-Based Imaging Modalities for Diagnosis and Management of Cutaneous Diseases

      Non-invasive bedside imaging tools are becoming more prevalent for assessing cutaneous lesions. Ultrasound used at specific frequencies allows us to assess margins of lesions to minimize the extent of the biopsy that is performed and improve cosmetic outcomes. Vascularity, seen on Doppler ultrasound and contrast-enhanced ultrasound, and stiffness, assessed on tissue elastography, can help differentiate between benign and malignant lesions for clinicians to be more judicious in deciding whether to biopsy. Moreover, research has shown the efficacy in using ultrasound in monitoring flares of hidradenitis suppurativa, a disease affecting apocrine gland-rich areas of the body, for which the current gold ...

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    13. Two optical coherence tomography systems detect topical gold nanoshells in hair follicles, sweat ducts and measure epidermis

      Two optical coherence tomography systems detect topical gold nanoshells in hair follicles, sweat ducts and measure epidermis

      Optical coherence tomography (OCT) is an optical imaging technology that enables real time, high‐resolution, cross‐sectional and en face investigation of skin by detecting reflected broad‐spectrum near‐infrared light from tissue. OCT provides micron‐scale spatial resolution and millimeter‐scale depth of penetration [1]. Several commercial OCT systems with handheld probes targeted for Dermatology are now available [2].

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    14. OCT image atlas of healthy skin on sun‐exposed areas - O'Leary - - Skin Research and Technology - Wiley Online Library

      OCT image atlas of healthy skin on sun‐exposed areas - O'Leary - - Skin Research and Technology - Wiley Online Library

      Background Skin cancer represents the most prevalent type of cancer in the United States. Excision of these lesions can leave significant scarring, and a delay in the diagnosis of malignant melanoma could result in metastasis or death. Therefore, developing technology and criteria to accurately diagnose these cancers is of particular importance to the medical community. While biopsy can lead to scarring and infections, dermoscopy and confocal microscopy offer noninvasive imaging methods but are also limited in their ability to determine tumor depth and margins. Optical coherence tomography (OCT) is a promising imaging method that uses near‐infrared light backscattering to ...

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    15. Reflectance confocal microscopy and optical coherence tomography for the diagnosis of bullous pemphigoid and pemphigus and surrounding subclinical lesions

      Reflectance confocal microscopy and optical coherence tomography for the diagnosis of bullous pemphigoid and pemphigus and surrounding subclinical lesions

      Background Diagnosis of bullous pemphigoid (BP) and pemphigus is based on clinical features, histology, immunofluorescence and laboratory data. Objectives To evaluate features of BP and pemphigus at reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) in order to provide a rapid non‐invasive bed‐side diagnosis. Secondary objective was to evaluate the detectability of clinically non‐visible lesions. Methods This was an observational, retrospective, multicentre study in which patients with suspicious lesions for BP or pemphigus underwent clinical assessment, RCM, OCT, blood tests and skin biopsy for histological and direct immunofluorescence examinations from January 2014 to December 2015. A ...

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    16. Angiographic optical coherence tomography imaging of hemangiomas and port wine birthmarks

      Angiographic optical coherence tomography imaging of hemangiomas and port wine birthmarks

      Objectives A current therapeutic challenge of vascular lesions is that they do not always respond effectively to laser treatment. Information on targeted vessels could potentially be used to guide laser treatments. Optical coherence tomography (OCT) is a useful tool for the non‐invasive imaging of tissues, including skin hemangiomas and port wine birthmarks. Dynamic OCT is able to rapidly characterize cutaneous blood vessels. The primary goal of this study was to demonstrate the ability of bedside OCT to image (i) overall vessel pattern; (ii) individual vessel morphology, diameter and depth; and (iii) total vessel density as a function of depth ...

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    17. In-vivo detection of the skin dermo-epidermal junction by ultrahigh resolution optical coherence tomography

      In-vivo detection of the skin dermo-epidermal junction by ultrahigh resolution optical coherence tomography

      The human skin is comprised by two layers; epidermis and dermis, separated by the dermo-epidermal junction (DEJ). The relevance of depicting DEJ and measurement of the epidermal thickness (ET) is e.g. seen for superficial skin cancers where delineation of DEJ is of prime prognostic importance. Another example is diagnosis of psoriasis where a thickened epidermis and a ridged DEJ is a hallmark. Histopathological examination of biopsied tissue is traditionally performed to trace DEJ and measure ET. An efficient and precise method to locate DEJ and measure ET is optical coherence tomography (OCT) which is an in vivo and non-invasive ...

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    18. Association of skin autofluorescence with plaque vulnerability evaluated by optical coherence tomography in patients with cardiovascular disease

      Association of skin autofluorescence with plaque vulnerability evaluated by optical coherence tomography in patients with cardiovascular disease

      Background and aims Accumulation of advanced glycation end products (AGEs) can be measured non-invasively by skin autofluorescence (SAF) whose values are elevated in patients with cardiovascular disease (CVD). Optical coherence tomography (OCT) is an intravascular imaging modality that could allow visualization of plaque composition. We aim to examine the relationship between SAF and plaque composition evaluated by frequency-domain OCT in patients with CVD. Methods We prospectively enrolled 108 patients with CVD who underwent OCT images during percutaneous coronary intervention (PCI). We divided the population into two groups: high SAF group (greater than or equal to 2.6) and low SAF ...

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    19. Label-free, multi-contrast optical coherence tomography for study of skin melanoma mice in vivo

      Label-free, multi-contrast optical coherence tomography for study of skin melanoma mice in vivo

      The lymphatic system plays an important role in inflammation and cancer such as melanoma. Due to the limitations of current developed imaging techniques, visualization of lymphatic vessels within the tissue in vivo has been challenging. Optical imaging of lymphatic vessel is gaining increased interests because it does not involve any radiation and can achieve very high resolution. Here, we developed a multi-contrast, label-free optical coherence tomography (OCT) imaging technology with an axial resolution of ~ 5 μm and lateral resolution of ~ 7 μm, which is capable of providing microstructural information and microcirculatory system including blood and lymphatic vessels simultaneously. Using this ...

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    20. Structural characterization on in vitro porcine skin treated by ablative fractional laser using optical coherence tomography

      Structural characterization on in vitro porcine skin treated by ablative fractional laser using optical coherence tomography

      Ablative fractional skin laser is widely applied for various skin conditions, especially for cosmetic repairing and promoting the located drug delivery. Although the influence of laser treatment over the skin has been explored before in means of excision and biopsy with microscopy, these approaches are invasive, only morphological and capable of distorting the skin. In this paper the authors use fresh porcine skin samples irradiated by the lasers, followed by detected by using Optical Coherence Tomography (OCT). This advanced optical technique has the ability to present the high resolution structure image of treated sample. The results shows that laser beams ...

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    21. Optical coherence tomography for the diagnosis of malignant skin tumors: a meta-analysis

      Optical coherence tomography for the diagnosis of malignant skin tumors: a meta-analysis

      Optical coherence tomography (OCT) is an emergent imaging tool used for noninvasive diagnosis of skin diseases. The present meta-analysis was carried out to assess the accuracy of OCT for the diagnosis of skin cancer. We conducted a systematic literature search though EMBASE, Medline, PubMed, the Cochrane Library, and Web of Science database for relevant articles published up to June 6, 2017. The quality of the included studies was assessed using the QUADAS-2 tool and the Oxford Levels of Evidence Scale. Statistical analyses were conducted using the software Meta-Disc version 1.4 and STATA version 12.0. A total of 14 ...

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    22. The use of optical coherence tomography to analyze the efficacy of skin care products

      The use of optical coherence tomography to analyze the efficacy of skin care products

      In this study, we assess the applicability of optical coherence tomography (OCT) for non-invasive imaging of skin morphology for the assessment of efficacy of cosmetic skin wrinkle-reduction products in humans. Evaluation of skin care products for reduction of facial wrinkles is largely limited to photographic (non-quantitative) comparison of skin surface texture before and after either single or prolonged application of skin care product. OCT could be a technique for monitoring changes in cross-sectional skin morphology. An optical attenuation coefficient analysis is also carried out to quantitatively study the changes in different layers of the skin.

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