Cellular features of psoriatic skin: Imaging and quantification using in vivo reflectance confocal microscopy

Wolberink, E.A.W.; Erp, P.E.J. van; Teussink, Michel; Kerkhof, P.C.M. van de; Gerritsen, Marinel

doi:10.1002/cyto.b.20575

Cited by 47 publications

(70 citation statements)

References 25 publications

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“…Currently, RCM has the best resolution, albeit at the cost of a very limited depth of imaging. In consequence, RCM criteria for a number of diagnoses have been established comparing the method with histology [2–6, 14–17, 19, 20, 22, 23, 25, 26]. HD-OCT is a promising high-resolution imaging technique which offers comparable resolution to RCM and improved penetration [9–11].…”

Section: Discussionmentioning

confidence: 99%

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High-definition optical coherence tomography: adapted algorithmic method for pattern analysis of inflammatory skin diseases: a pilot study

et al. 2013

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High-definition optical coherence tomography (HD-OCT) is a non-invasive technique for morphological investigation of tissue with cellular resolution filling the imaging gap between reflectance confocal microscopy and conventional optical coherence tomography. The aim of this study is first to correlate dermatopathologic descriptors of inflammatory skin conditions with epidermal alteration to features observed by HD-OCT. Secondly, to assess the discriminative accuracy of common inflammatory reaction patterns with epidermal alteration using HD-OCT by applying Ackerman’s algorithmic method of pattern recognition. The generated HD-OCT images of 160 patients presenting an inflammatory skin disease were analyzed with respect to the following criteria: visualization of individual cells in the epidermis and dermis and morphology of dermo-epidermal junction, papillary dermis and reticular dermis. A set of morphological features corresponding to dermatopathological descriptors are obtained and the discriminative accuracy of HD-OCT of inflammatory reaction patterns could be demonstrated. These patterns are spongiotic dermatitis, psoriasiform dermatitis, interface dermatitis and ballooning dermatitis. Additional studies to test the sensitivity and specificity of the proposed algorithm for pattern analysis are essential. The other categories of Ackerman’s pattern recognition need to be evaluated. This study provides a set of morphological features generated by HD-OCT imaging very similar to those described for reflectance confocal microscopy but with the advantages not only to visualize individual cells up to a depth of 570 μm but also in both slice and en face mode. An adapted algorithmic method for pattern analysis of common inflammatory skin diseases could be proposed. This new technique appears to be a promising method for non-invasive diagnosis, evaluation and management of common inflammatory skin diseases.

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Section: Discussionmentioning

confidence: 99%

“…One of the restrictions of RCM in evaluating inflammatory skin diseases is the limited penetration depth [2–6, 14–17, 19, 20, 22, 23, 25, 26]. With HD-OCT not only the visualization and assessment of individual cells but also microanatomic structures can be performed to a depth of 570 μm.…”

Section: Discussionmentioning

confidence: 99%

High-definition optical coherence tomography: adapted algorithmic method for pattern analysis of inflammatory skin diseases: a pilot study

et al. 2013

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“…Further, well-established histological features of psoriasis and other inflammatory skin lesions can be visualized with this technique, including characteristic PMN accumulations. It has been shown that these RCM images correlated highly with histology (27)(28)(29)(30)(31).…”

Section: Introductionmentioning

confidence: 94%

Establishing the dynamics of neutrophil accumulation in vivo by reflectance confocal microscopy

Wolberink

Peppelman

Kerkhof

et al. 2014

Experimental Dermatology

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Reflectance confocal microscopy (RCM) is an imaging tool, which visualizes the epidermal skin layers in vivo with a cellular resolution. Neutrophil accumulation is a characteristic feature in psoriasis and is thought to play a role in the pathophysiology of psoriasis. Until now, imaging of neutrophil accumulation in vivo is not performed. We evaluated the dynamics of neutrophil migration in active psoriatic lesions by non-invasive RCM imaging. Additionally, we evaluated the time phasing and duration of neutrophil trafficking. We performed RCM imaging prior to the start of topical treatment and for seven consecutive days with a 24-h time interval at the Radboud University Medical Center, Nijmegen, the Netherlands. Twelve psoriatic lesions in three patients with a severe exacerbation of psoriasis were included. The four most active lesions were selected in each patient based on the highest degree of redness, induration and expansion in the previous 2 weeks. In all lesions, a cyclic pattern of neutrophil migration was observed, consisting of squirting papillae, transepidermal migration, accumulation in the stratum spinosum, accumulation in the stratum corneum and degeneration of the abscesses. The time interval of a neutrophil-trafficking cycle was 5-7 days and showed a synchronic time phasing. This study is the first to establish the dynamics and time phasing of neutrophil migration in vivo in psoriatic lesions. Previously reported theories were confirmed by these novel in vivo data. RCM might distinguish between active or chronic psoriatic areas, which might contribute to new insights into the pathogenesis of psoriasis.

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“…CRM is a valuable tool to evaluate histological features of psoriasis (Figure 18), and the findings correlate with histology [97][98][99].…”

Section: Crm and Other Skin Diseasesmentioning

confidence: 99%

Confocal Laser Scanning Microscopy as a Tool for the Investigation of Skin Drug Delivery Systems and Diagnosis of Skin Disorders

Rossetti¹,

Depieri²,

Bentley³

2013

Confocal Laser Microscopy - Principles and Applications in Medicine, Biology, and the Food Sciences

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Cellular features of psoriatic skin: Imaging and quantification using in vivo reflectance confocal microscopy

Cited by 47 publications

References 25 publications

High-definition optical coherence tomography: adapted algorithmic method for pattern analysis of inflammatory skin diseases: a pilot study

High-definition optical coherence tomography: adapted algorithmic method for pattern analysis of inflammatory skin diseases: a pilot study

Establishing the dynamics of neutrophil accumulation in vivo by reflectance confocal microscopy

Confocal Laser Scanning Microscopy as a Tool for the Investigation of Skin Drug Delivery Systems and Diagnosis of Skin Disorders

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