Line‐field confocal optical coherence tomography for non‐invasive diagnosis of lichenoid dermatoses of the childhood: A case series

Abstract

The differential diagnosis of lichenoid dermatoses of the childhood (ie lichen nitidus [LN], lichen spinulosus [LSpi], lichen striatus [LStr], keratosis pilaris [KP]) can be challenging. Many of these uncommon cases remain indeed misdiagnosed, also because of overlapping forms, coexistence of atopic dermatitis or previous inappropriate treatments. [1][2][3][4] Line-field confocal optical coherence tomography (LC-OCT) is a recently developed non-invasive imaging technique able to provide real-time, high-resolution images of the skin up to a 500µm depth, both within the normal 5 and pathological spectrum. [6][7][8][9][10] We examined 10 patients (8 males and 2 females; median age 8.4 [3-16] years) affected by lichenoid dermatoses of the childhood, namely LN (3), LSpi (1), LStr (1) and KP (5). Non-invasive examinations LC-OCT, lichen nitidus, lichen planus, lichen spinulosus, RCM

Line‐field confocal optical coherence tomography: a new tool for non‐invasive differential diagnosis of pustular skin disorders

“…Our group has successfully used LC-OCT to investigate the morphology of epidermis and adnexal structures in both healthy skin, 8 skin cancers and their simulators, [9][10][11] vesicobullous 12 and inflammatory conditions, 13 rare epidermal diseases [14][15][16][17] and uncommon paediatric conditions. 18,19 The accuracy of RCM in characterizing pustular rashes was previously demonstrated by Debarbieux et al, 7 while standard OCT was employed to characterize Malassezia folliculitis pustules, 20 and dermoscopy was employed to imagine acute severe erythemato-pustular rashes. 21 In this preliminary descriptive study, we aimed to investigate, for the first time, the potentialities and usefulness of the LC-OCT device in the non-invasive differential diagnosis of a series of PSD of the adult having different aetiologies, body location, microscopic features and incidence rates.…”

“…The device is based on a supercontinuum laser, that, briefly, combines the technological advances of reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) in terms of cellular and spatial resolution and vertical/horizontal navigation. Our group has successfully used LC‐OCT to investigate the morphology of epidermis and adnexal structures in both healthy skin, 8 skin cancers and their simulators, 9–11 vesicobullous 12 and inflammatory conditions, 13 rare epidermal diseases 14–17 and uncommon paediatric conditions 18,19 . The accuracy of RCM in characterizing pustular rashes was previously demonstrated by Debarbieux et al ., 7 while standard OCT was employed to characterize Malassezia folliculitis pustules, 20 and dermoscopy was employed to imagine acute severe erythemato‐pustular rashes 21 …”

“…The line-field confocal optical coherence tomography (LC-OCT) is a recently developed imaging technique able to perform a non-invasive, in vivo, examination of the epidermis and upper dermis, reaching very high image resolution and virtual histology. [8][9][10][11][12][13][14][15][16][17][18][19] The device is based on a supercontinuum laser, that, briefly, combines the technological advances of reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) in terms of cellular and spatial resolution and vertical/ horizontal navigation. Our group has successfully used LC-OCT to investigate the morphology of epidermis and adnexal structures in both healthy skin, 8 skin cancers and their simulators, [9][10][11] vesicobullous 12 and inflammatory conditions, 13 rare epidermal diseases [14][15][16][17] and uncommon paediatric conditions.…”

“…The line‐field confocal optical coherence tomography (LC‐OCT) is a recently developed imaging technique able to perform a non‐invasive, in vivo , examination of the epidermis and upper dermis, reaching very high image resolution and virtual histology 8–19 . The device is based on a supercontinuum laser, that, briefly, combines the technological advances of reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) in terms of cellular and spatial resolution and vertical/horizontal navigation.…”

Morphological evaluation of melanocytic lesions with three-dimensional line-field confocal optical coherence tomography: correlation with histopathology and reflectance confocal microscopy. A pilot study

“…The features of basal cell carcinoma (BCC), actinic keratosis, squamous cell carcinoma, sebaceous hyperplasia, xanthogranuloma, herpes, scabies, Kaposi sarcoma, aquagenic keratoderma, bullous diseases and normal skin have been described with this technology. [2][3][4][5][6][7][8][9][10][11][12][13][14] RCM and OCT are two other noninvasive technologies, which have different resolutions and depths of penetration into the skin. RCM enables an en face view with cellular resolution (spatial lateral resolution of 1 lm, similar to histology and axial resolution of < 5 lm).…”