In vivo quantification of epidermis pigmentation and dermis papilla density with reflectance confocal microscopy: variations with age and skin phototype

Abstract

Reflectance confocal microscopy (RCM) may help to quantify variations of skin pigmentation induced by different stimuli such as UV radiation or therapeutic intervention. The objective of our work was to identify RCM parameters able to quantify in vivo dermis papilla density and epidermis pigmentation potentially applicable in clinical studies. The study included 111 healthy female volunteers with phototypes I-VI. Photo-exposed and photo-protected anatomical sites were imaged. The effect of age was also assessed. Four epidermis components were specifically investigated: stratum corneum, stratum spinosum, basal epidermal layer and dermo-epidermal junction. Laser power, diameter of corneocytes and upper spinous keratinocytes, brightness of upper spinous and interpapillary spinous keratinocytes, number of dermal papillae and papillary contrast were systematically assessed. Papillary contrast measured at the dermo-epidermal junction appeared to be a reliable marker of epidermis pigmentation and showed a strong correlation with skin pigmentation assessed clinically using the Fitzpatrick's classification. Brightness of upper spinous and interpapillary spinous keratinocytes was not influenced by the skin phototype. The number of dermal papillae was significantly lower in subjects with phototypes I-II as compared with darker skin subjects. A dramatic reduction in the number of dermal papillae was noticed with age, particularly in subjects with fair skin. The method presented here provides a new in vivo investigation tool for quantification of dermis papilla density and epidermal pigmentation. Papillary contrast measured at the dermo-epidermal junction may be selected as a marker of skin pigmentation for evaluation in clinical studies.

Application of Photoacoustic Methods and Confocal Microscopy for Monitoring of Therapeutic Response in Plaque Psoriasis

“…The assessment of the dermal papillae can also be impeded by low melanin concentrations and, consequently, low contrast CLSM images [34,45]. Lagarrigue et al [46] could show in a study on 111 volunteers that the papillary contrast as measured in the dermo-epithelial junction seems to be a reliable marker for skin pigmentation and clearly correlates with the skin types according to the Fitzpatrick classification [30]. Consequently, an assessment of the dermal papillae in patients of skin types I and II according to the Fitzpatrick classification [30] is impeded [45,46].…”

Assessment of skin pigmentation by confocal microscopy: Influence of solar exposure and protection habits on cutaneous hyperchromias

“…A potential application of RCM (VivaScope ® 1500; Lucid, Rochester, NY, USA) to cosmetology is the quantification of epidermal pigmentation, contributing to the quantification of variations in skin pigmentation induced by UV radiation or by therapeutic intervention …”

A Marked Poisson Process Driven Latent Shape Model for 3D Segmentation of Reflectance Confocal Microscopy Image Stacks of Human Skin

“…The framework of our model can be adapted to different applications by choosing the appropriate shape prior based on domain knowledge. In developing this model, we were inspired by the problem of finding the boundary between superficial cellular epithelium and underlying connective tissue, a commonly encountered problem in tissue microscopy [5], [1], [6]. Specifically we address a special case of this general application; delineation of the boundary between epidermis (i.e., epithelium) and dermis (i.e., connective tissue) in 3D image stacks of reflectance confocal microscopy (RCM) images of human skin in vivo .…”

“…The signal-to-noise and contrast in RCM images, while sufficient to reveal critical features, varies with skin pigmentation. Thus, the ability to delineate the DEJ and analyze features and morphologic patterns remains limited, at present, to well-trained experts [5]. Currently, the DEJ is identified in RCM by expert readers, who manually and laboriously read the images in sequence through the z-stacks.…”