A new technique to map vulva microcirculation using laser Doppler perfusion imager

Abstract

The location of the vulva has had limited technologic progress in the assessment of the skin microcirculation and its application to clinical practice. Our group previously demonstrated increased perfusion in vulvar cancer compared to adjacent uninvolved skin with the laser Doppler flowmetry (LDF). The LDF is severely limited by its low spatial resolution (∼1 mm2) and pressure involved in positioning of the probe, which may affect value of the underlying tissue perfusion. Topographic perfusion mapping of the whole vulvar skin using LDF is also time consuming and is not clinically practical. We describe for the first time the application of the novel laser Doppler perfusion imager (LDPI) to map vulvar skin blood flow and give example in two cases with well-defined vulvar pathology—psoriasis and lichen sclerosus with invasive neoplasia—and discuss the potential of LDPI to study vulvar skin blood flow.

Dermatoscopy and Optical Coherence Tomography in Vulvar High-Grade Squamous Intraepithelial Lesions and Lichen Sclerosus: A Prospective Observational Trial

“…These stiff vessels translated into the observed increase in blood flow in lesional LS vulvar skin, as measured by D-OCT. We hypothesize that this could be the result of sclerosis and damage to the connective tissue in LS, affecting the microvasculature of the dermis 29 . The observed increase in dermal blood flow in genital LS has not previously been objectified by D-OCT, but are in agreement with previous descriptions using laser Doppler and in 3 patients with extragenital LS 30,31 . Histologically, the vulvar epidermis in LS is thinner compared with healthy vulvar skin 21 .…”

“…29 The observed increase in dermal blood flow in genital LS has not previously been objectified by D-OCT, but are in agreement with previous descriptions using laser Doppler and in 3 patients with extragenital LS. 30,31 Histologically, the vulvar epidermis in LS is thinner compared with healthy vulvar skin. 21 We confirm epidermal thinning in LS numerically and morphologically using noninvasive, structural OCT measurements.…”