Line‐field confocal optical coherence tomography of cutaneous vascular lesions: Morphological assessment and histopathological correlations

Abstract

Background Cutaneous vascular lesions (VLs) are benign or malignant processes involving blood and/or lymphatic vessels, usually readily diagnosed with dermoscopy. However, cases showing unclear clinical/dermoscopic findings may require further investigations. Line‐field confocal optical coherence tomography (LC‐OCT) is a new, non‐invasive imaging technique displaying high resolution and deep penetration. The aim of this study was to describe the LC‐OCT features of the most common benign and malignant VLs and to correlate them with histopathological substrates. Methods Clinical, dermoscopic, LC‐OCT and histopathological images of VLs were retrospectively collected. Detailed LC‐OCT description and histopathological correlations were produced for different types of VLs. Results The study included 71 VLs belonging to 50 caucasian patients [31 (62%) females; median age 56.8 (30–83) years] study lesions included 25 cherry haemangiomas, 15 angiokeratomas, 10 thrombosed haemangiomas, six pyogenic granulomas, five venous lakes, four targetoid haemosiderotic haemangiomas, four Kaposi's sarcomas and two extraungual glomus tumours. LC‐OCT detected increased dermal vascularity, assuming different size and shape according to the particular type of VLs. LC‐OCT criteria correlated well to established histopathologic findings. Conclusion The results of our preliminary observations indicate that in vivo evaluation with LC‐OCT may provide practical clues for the identification of the vascular nature of a lesion and its differential diagnosis.

Line‐field confocal optical coherence tomography of eyelid margin growths: A case series

“…The LC-OCT features that we observed in BCC, SCC, compound/dermal nevus, seborrheic keratosis, and pyogenic granuloma are in line with those already reported for the same lesions in other cutaneous areas. 6,7,9,16,17 In eyelid BCC (Figure 1 Based on our preliminary findings, some considerations can be made. LC-OCT is perfectly suitable for the examination of lesions of this anatomic region, as the handheld probe may be easily positioned and rapidly moved also on eyelid margin for the real-time evaluation and the image acquisition.…”

“…The LC‐OCT features that we observed in BCC, SCC, compound/dermal nevus, seborrheic keratosis, and pyogenic granuloma are in line with those already reported for the same lesions in other cutaneous areas. 6 , 7 , 9 , 16 , 17 In eyelid BCC (Figure 1 ), LC‐OCT revealed the typical diagnostic findings, including tumor basaloid islands with a laminated, “millefeuilles”, structure and dark clefting, altered dermoepidermal junction (DEJ), and prominent vessels. In eyelid SCC, LC‐OCT revealed hyperkeratosis with acanthosis, marked atypical epidermal pattern, disrupted DEJ, and tumor budding and dilated vessels in the upper dermis.…”

Subclinical, early hair regrowth in alopecia areata patients under treatment with baricitinib detected by line‐field confocal optical coherence tomography evaluation

“…4 Line-field confocal optical coherence tomography (LC-OCT) is a recently introduced non-invasive technique for in vivo, real-time skin imaging with cellular level definition and penetration depth of up to 500 μm that provides both vertical and horizontal 'virtual' sections and has been demonstrated to be useful in a variety of skin disorders. [5][6][7][8][9][10] LC-OCT is able to clearly show the epidermal and superficial/mid dermal structures along with the upper portion of the hair follicle including the hair shaft (Figure 1).…”

Progress in Dermatology and Venereology in 2023 as reflected in the Journal of the European Academy of Dermatology and Venereology

“…2 Line-field confocal optical coherence tomography can provide practical hints for the diagnoses of vascular lesions as studied in cherry hemangiomas, angiokeratomas, thrombosed haemangiomas and Kaposi sarcomas. 3 A topical mTOR inhibitor (rapamycin) has shown marked effects in the treatment of facial angiofibromas with 90% improvement in 39 reports about a total of 483 patients. 4…”

“…Line‐field confocal optical coherence tomography can provide practical hints for the diagnoses of vascular lesions as studied in cherry hemangiomas, angiokeratomas, thrombosed haemangiomas and Kaposi sarcomas 3 …”