Introduction to reflectance confocal microscopy and its use in clinical practice

Levine, Amanda; Markowitz, Orit

doi:10.1016/j.jdcr.2018.09.019

Cited by 79 publications

(92 citation statements)

References 63 publications

(117 reference statements)

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“…Lastly, epidermal thickness was assessed using RCM. The images with cellular resolution allow very detailed measurements of the epidermal layer [27]. Earlier work showed very good correspondence of RCM and histology for epidermal thickness measurements [34].…”

Section: Discussionmentioning

confidence: 88%

Noninvasive Skin Barrier Assessment: Multiparametric Approach and Pilot Study

et al. 2019

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The epidermal barrier function is disrupted in various inflammatory skin diseases. Accurate methods to measure skin barrier function are needed to assess the effect of therapeutic agents. Therefore, we developed a noninvasive multiparametric approach to measure four different parameters regarding the skin barrier. In the current pilot study, we evaluate this method in 14 healthy volunteers. We assessed erythema, transepidermal water loss (TEWL), water content, and epidermal thickness at both cheeks before and 30 min after application of Lanette and Vaseline-Lanette cream. For this, we used spectrophotometry, the Aquaflux device, the Epsilon device, and reflection confocal microscopy, respectively. Stratum corneum (SC) thickness was significantly increased after application of both creams (p < 0.05), and this increase was larger after Lanette cream compared to after Vaseline-Lanette cream (p = 0.035). Erythema, TEWL, and water content did not significantly change after cream application. Our multiparametric approach is promising and offers a feasible and practical way to quickly obtain multifaceted information about skin barrier function. Further exploration of this approach after prolonged use of cream and in conditions of disrupted skin barrier are recommended areas for future research.

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Section: Discussionmentioning

confidence: 88%

Noninvasive Skin Barrier Assessment: Multiparametric Approach and Pilot Study

et al. 2019

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“…In histological sections, the inflammatory infiltrate in rosacea can be observed in both superficial and deeper skin layers (29,30). In the current study, the DEJ was used as a representative level to score inflammation, because deeper layers impair detailed vision due to reduced image resolution and co-presence of bright collagen bundles (2). No changes in inflammatory cell number at the DEJ were measured, which may be due to the difficulty of differentiating inflammatory cells from pigmented keratinocytes and melanocytes, which all are visible as polygonal, bright structures (Figure 4(c,d)) (2,55).…”

Section: Discussionmentioning

confidence: 95%

Value of reflectance confocal microscopy for the monitoring of rosacea during treatment with topical ivermectin

Logger

Peppelman²,

Erp

et al. 2020

Journal of Dermatological Treatment

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Background: Reflectance confocal microscopy (RCM) enables noninvasive Demodex mite detection in rosacea. Objective scoring of rosacea severity is currently lacking. Objectives: To determine the value of RCM for monitoring Demodex, inflammation and vascular parameters in rosacea during treatment. Methods: In 20 rosacea patients, clinical and RCM examination were performed before, during, and 12 weeks after a 16-week treatment course with topical ivermectin. Using RCM, number of mites and inflammatory cells, epidermal thickness, and vascular density and diameter were measured. RCM features were correlated with clinical assessment. Results: Treatment resulted in clinical reduction of inflammatory lesions. Mites were detected in 80% of patients at baseline, 30% at week 16, and 63% at week 28. The number of mites reduced significantly during treatment, but no changes in inflammatory cells, epidermal thickness or vascular parameters were observed. Correlation between number of inflammatory lesions and mites was low. None of the RCM variables were significant predictors for clinical success. Conclusions: RCM enables anti-inflammatory effect monitoring of topical ivermectin by determining mite presence. Quantifying exact mite number, and inflammatory and vascular characteristics is challenging due to device limitations. In its current form, RCM seems of limited value for noninvasive follow-up of rosacea in clinical practice.

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“…Furthermore, MRI is time-consuming and not cost-effective for routine use. Confocal laser scanning microscopy (CLSM) and multiphoton tomography (MPT) are superior with regard to resolution, but have a limited penetration depth of about 200 μm [5,9]. For example, for diagnosis of pemphigus, acantholytic cells could be seen in CLSM but not with OCT. Because of the lower resolution of OCT, some microscopic features could not be detected that would be useful for discriminating between autoimmune bullous diseases and other bullous skin lesions such as viral infections [10].…”

Section: Research For Clinical Practice Backgroundmentioning

confidence: 99%

Optical coherence tomography for fast bedside imaging, assessment and monitoring of autoimmune inflammatory skin diseases?

Hundt

2020

J Deutsche Derma Gesell

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Summary Optical coherence tomography (OCT) is a non‐invasive, high‐resolution imaging technique with a growing impact in dermatology. The principle of OCT is comparable to that of sonography, except that it uses infrared laser light instead of ultrasound waves. It has been clinically demonstrated that OCT is suitable for discriminating between different types of non‐melanoma skin cancer at an early stage of disease. Optical coherence tomography generates two‐ or three‐dimensional images of up to 2 mm penetration depth, a field of view of 6 mm × 6 mm, and an acquisition time of seconds. The resolution capability of OCT is more than 3 to 100 times higher than that of ultrasound imaging. It is of particular interest that the additional information on vasculature provided by OCT angiography enables the assessment and monitoring of inflammatory skin diseases. The use of OCT to locate exact blister levels was demonstrated for diagnosing autoimmune bullous diseases. It is anticipated that detection of subclinical lesions could indicate a relapse of the disease. In the future, this could enable intervention and early treatment. Furthermore, the development of high‐speed OCT could allow fast scanning and bedside imaging of large body sites.

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Introduction to reflectance confocal microscopy and its use in clinical practice

Cited by 79 publications

References 63 publications

Noninvasive Skin Barrier Assessment: Multiparametric Approach and Pilot Study

Noninvasive Skin Barrier Assessment: Multiparametric Approach and Pilot Study

Value of reflectance confocal microscopy for the monitoring of rosacea during treatment with topical ivermectin

Optical coherence tomography for fast bedside imaging, assessment and monitoring of autoimmune inflammatory skin diseases?

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