Line‐field confocal optical coherence tomography of actinic keratosis: a case series

Lenoir, Clément; Cinotti, Élisa; Tognetti, Linda; Cano, Carmen; Diet, G.; Miyamoto, Makiko; Rocq, Laureen; Trépant, Anne‐Laure; Pérez-Ánker, Javiera; Puig, Susana; Malvehy, Josep; Rubegni, Pietro; Perrot, Jean‐Luc; Marmol, Véronique Del; Suppa, Mariano

doi:10.1111/jdv.17548

Cited by 16 publications

(21 citation statements)

References 9 publications

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“…9,10 In actinic keratosis, LC-OCT shows, similarly to RCM, a variable degree of hyperkeratosis, acanthosis, and cellular and nuclear pleomorphism of keratinocytes, as reported by some studies. 10,[19][20][21] As regards solar lentigo/seborrheic keratosis, although a specific LC-OCT study has not been conducted so far, the expected findings, based on our experience, would be similar to those obtained with RCM, that is, hyperpigmentation of the basal layer, polycyclic papillary contour, bright branching tubular structures, and bulbous projections. 21 Finally, thanks to the integrated dermoscopic camera, LC-OCT may be useful to detect the most appropriate areas for biopsy as well as for surgical margins delineation, and for topical treatment monitoring.…”

Section: Discussionsupporting

confidence: 68%

“…However, this invasive procedure may be problematic, especially for large lesions of the face in elderly patients with comorbidities, therefore LC‐OCT may be crucial for narrowing down the number of unnecessary biopsies by ruling out other disorders such as pigmented actinic keratosis and solar lentigo/seborrheic keratosis 9,10 . In actinic keratosis, LC‐OCT shows, similarly to RCM, a variable degree of hyperkeratosis, acanthosis, and cellular and nuclear pleomorphism of keratinocytes, as reported by some studies 10,19–21 . As regards solar lentigo/seborrheic keratosis, although a specific LC‐OCT study has not been conducted so far, the expected findings, based on our experience, would be similar to those obtained with RCM, that is, hyperpigmentation of the basal layer, polycyclic papillary contour, bright branching tubular structures, and bulbous projections 21 .…”

Section: Discussionmentioning

confidence: 92%

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Line‐field confocal optical coherence tomography of lentigo maligna with horizontal and vertical histopathologic correlations

et al. 2022

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Lentigo maligna (LM) is a subtype of in situ melanoma that classically presents in elderly patients as a slowly growing lesion on sun‐exposed areas that may evolve to invasive melanoma. Line‐field confocal optical coherence tomography (LC‐OCT) is a new non‐invasive technique for a real‐time, vertical, and horizontal skin imaging with high resolution close to conventional histopathology. We present the LC‐OCT features of an LM of the nose in a 49‐year‐old white man along with their horizontal and vertical histopathological correlations. LC‐OCT was able to detect in vivo, in both horizontal and vertical imaging, the main microscopic features typical of LM by showing, in the epidermis and around the hair follicles, the presence of large, bright roundish, or dendritic atypical cells, with evident nuclei, corresponding to atypical melanocytes with a tendency toward folliculotropism. A strong correspondence between LC‐OCT images and vertical and horizontal histopathological sections was observed. Our study, although limited to a single case, is indicative of the great potential of LC‐OCT to improve the non‐invasive diagnosis of LM.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 92%

Line‐field confocal optical coherence tomography of lentigo maligna with horizontal and vertical histopathologic correlations

et al. 2022

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“…The usefulness of LC-OCT has been reported in a variety of skin disorders such as infectious diseases, autoimmune bullous diseases, skin tumours and other conditions. 1,3,[5][6][7][8][9][10][11][12][13][14] The aim of our study was to evaluate LC-OCT imaging in some common inflammatory skin disorders, that is plaque psoriasis, atopic eczema and lichen planus and to correlate the resulting features with histopathological findings.…”

Section: Introductionmentioning

confidence: 99%

Line‐field confocal optical coherence tomography of psoriasis, eczema and lichen planus: a case series with histopathological correlation

Verzì

Broggi

Micali

et al. 2022

Acad Dermatol Venereol

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Background Line-field confocal optical coherence tomography (LC-OCT) is a novel, non-invasive technique that provides in vivo, high-resolution images in both vertical and horizontal sections.Objectives The aim of the study was to evaluate LC-OCT imaging in some inflammatory disorders and to correlate the resulting features with histopathology.Methods The retrospective study included patients with histopathological confirmed diagnosis of plaque psoriasis, atopic eczema and lichen planus, who were imaged with LC-OCT before the biopsy. LC-OCT was performed with the commercially available LC-OCT device.Results A total of 15 adult patients with histopathologically proven plaque psoriasis (N: 5), atopic eczema (N: 5) and lichen planus (N: 5) were included. In all cases, LC-OCT allowed the in vivo recognition of the main microscopic features of the examined inflammatory skin disease, with a strong correlation with histopathology.Conclusions Although future studies on larger series of patients are necessary, LC-OCT, based on these preliminary findings, may represent a promising tool in inflammatory skin disorders with potential applications including enhanced diagnosis, biopsy guidance, follow-up and treatment monitoring.

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“…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).…”

Section: Introductionmentioning

confidence: 99%

“…It enables skin visualization in real time with cellular resolution, reaching the deep papillary dermis. 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 2–14 …”

Section: Introductionmentioning

confidence: 99%

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

Pérez-Ánker

Puig

Alós

et al. 2022

Clinical and Experimental Dermatology

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Background Line‐field confocal optical coherence tomography (LC‐OCT) is a new in vivo emerging technique that provides cellular resolution, allows deep imaging (400 μm) and produces real‐time images in both the horizontal and vertical plane and in three dimensions. No previous description of different subtypes of melanocytic lesions and their correlation with histopathology and reflectance confocal microscopy has been reported. Aim To describe the features of melanocytic lesions by LC‐OCT and their correlation with histopathology and reflectance confocal microscopy (RCM) findings. Methods Selected melanocytic benign lesions and melanomas were imaged in vivo with RCM and LC‐OCT at the Fundación Hospital Clinic (Barcelona, Spain). A minimum area of 4 × 4 mm (block image) at four depths (stratum granulosum, suprabasal, layer dermoepidermal junction and upper dermis) were acquired with RCM and a minimum of three cubes with LC‐OCT. Horizontal, vertical sections and three‐dimensional (3D) cubes of LC‐OCT were matched with RCM (Vivablock two‐dimensional composite mosaic) and histopathology, with ~5 μm lateral resolution accuracy (the same cell nuclei were measured in X, Y and Z) and evaluated by three observers experienced in using RCM and histopathology. Results In total, 12 melanocytic tumours (2 in situ melanomas, 2 invasive melanomas, 4 atypical naevi, 2 intradermal naevi, 1 compound naevus and 1 junctional naevus) were included. High correlation with 5 μm accuracy between RCM and LC‐OCT was observed for each tumour. The 3D images of melanocytic lesions were obtained with cellular resolution and correlated with both RCM and histopathology, allowing an understanding of the architecture and precise correlation at the cellular level with RCM. Similarities between LC‐OCT and RCM for the described diagnostic features and architecture (nests of melanocytic cells, ringed and meshwork pattern, and cellular details of tumour cells as dendritic and pagetoid cells) were confirmed. The main advantage of diagnosis by RCM fixed probe was the ability to produce larger scans of the lesion using mosaicing compared with an LC‐OCT handheld probe. Conclusion LC‐OCT allows the architectural and cellular description of different types of melanocytic lesions. LC‐OCT showed high correlation with histopathology (vertical sections) and RCM (horizontal sections) in melanocytic lesions. Diagnostic criteria for RCM were similar to those for LC‐OCT.

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Line‐field confocal optical coherence tomography of actinic keratosis: a case series

Abstract: Long-term safety of combination treatment with methotrexate and tumor necrosis factor (TNF)-a antagonists versus TNF-a antagonists alone in psoriatic patients.

Cited by 16 publications

References 9 publications

Line‐field confocal optical coherence tomography of lentigo maligna with horizontal and vertical histopathologic correlations

Line‐field confocal optical coherence tomography of lentigo maligna with horizontal and vertical histopathologic correlations

Line‐field confocal optical coherence tomography of psoriasis, eczema and lichen planus: a case series with histopathological correlation

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

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