Confocal laser‐scanning capillaroscopy: a novel approach to the analysis of skin capillaries in vivo

Abstract

This new approach offers a considerable advantage compared with nailfold capillaroscopy, which can only be performed at the proximal nail segment, and over histological analysis, which can be hampered by fixation artifacts resulting in altered size and shape of the vessels to be analyzed. CLSC could allow for precise analysis of in vivo skin vasculature in systemic and proliferative diseases of the skin.

Noninvasivein vivodetection and quantification ofDemodexmites by confocal laser scanning microscopy

“…[11][12][13][14][15][16][17][18][19][20] A rising number of other indications includes the differentiation between allergic and toxic dermatitis, [21][22][23] the evaluation of inflammatory diseases such as psoriasis, lichen planus or lupus erythematosus [24][25][26] as well as the examination of capillaries in the skin and nails. [27][28][29] However, fungal (dermatophytes) and parasitic (scabies, Demodex) infestations can also be visualized by CLSM, 28,30,31 and very recently Longo et al 32 described the typical appearance of Demodex mites in CLSM.…”

“…The method is already well established for the visualization of pigmented lesions to distinguish between benign or dysplastic naevi and melanoma of the skin 1–10 and nonmelanoma skin cancer 11–20 . A rising number of other indications includes the differentiation between allergic and toxic dermatitis, 21–23 the evaluation of inflammatory diseases such as psoriasis, lichen planus or lupus erythematosus 24–26 as well as the examination of capillaries in the skin and nails 27–29 . However, fungal (dermatophytes) and parasitic (scabies, Demodex ) infestations can also be visualized by CLSM, 28,30,31 and very recently Longo et al.…”

Quantification of capillary blood cell flow using reflectance confocal microscopy

“…IVCM is a new in vivo transcutaneous imaging method to study cutaneous microcirculation. It is non‐invasive and allows observing the capillary flow and imaging the tissue under observation, evaluating parameters like skin thickness, epidermal cell size, number of capillaries/mm 2 , size, shape, and depth of the microvessels .…”

In vivo reflectance confocal microscopy features of cutaneous microcirculation and epidermal and dermal changes in diffuse systemic sclerosis and correlation with histological and videocapillaroscopic findings

“…The usefulness, reliability and versatility of in vivo RCM for non-invasive imaging of blood capillaries of the upper dermis of any explorable area of healthy skin have been recently reported [8]. This application is known as "confocal laser-scanning capillaroscopy" and it has been used to assess and quantify the morphological and dynamic changes of microcirculation occurring in normal skin under external stress conditions, such as cigarette smoking [26] and environmental temperature [27].…”

“…melanin, keratin and cytoplasm. This technique produces horizontal parallel optical sections of the skin from the stratum corneum to the upper reticular dermis, including the upper dermal plexus and capillary loops, with a penetration depth ranging from 200 m to 250 m from the skin surface [8].…”