Microscopic and functional changes observed with dynamic optical coherence tomography for severe refractory atopic dermatitis treated with dupilumab

Abstract

Atopic dermatitis (AD) is a chronic inflammatory, intensely pruritic disease, primarily presenting in early childhood with a prevalence of 2%-8% in the adult population. 1,2 The physiopathology of AD is the result of complex interactions between genetic and environmental factors, leading to a skin barrier dysfunction and an increased risk of skin infections. Diagnosis is performed clinically, and currently, there are no pathognomonic laboratory or imaging biomarkers for AD diagnosis. 1

Instrumental evaluation of skin barrier function and clinical outcomes during dupilumab treatment for atopic dermatitis: An observational study

“…9,10 Subsequently, the same processes have been analyzed in patients with AD during dupilumab Microscopic and functional improvements of epidermal remodeling and inflammation have been observed with dynamic optical coherence tomography in patients affected by severe AD and treated with dupilumab. 11 Previous authors have investigated cutaneous biophysical parameters in atopic dermatitis demonstrating an alteration of skin barrier function followed by a TEWL increase. The loss in skin barrier integrity results in an increase of TEWL both on damaged and non-damaged atopic skin.…”

Radiotherapy‐induced subclinical skin changes revealed by dynamic optical coherence tomography: a case‐controlled pilot study

“…The data are not publicly available due to privacy or ethical restrictions. Dermo-epidermal junction Undulated line that separates the epidermis and the dermis 7 Collagen density Is a measure of collagen thickness that is calculated according to the exponential decrease in the OCT signal with depth in a selected region of interest (ROI) 5 Dermal hypoechogenic areas Hypoechogenic horizontal areas with no clear vascular signal Dots, blobs, coiled, lined, curved, serpiginous, mottle, mesh, branching…”

“…Dynamic optical coherence tomography (D-OCT) is a noninvasive imaging technique, which is increasingly being applied to the study of physiologic and pathologic skin changes, inflammatory skin diseases and malignant and non-malignant tumour detection. 5,6 The aim of our study was to identify subclinical changes evidenced with D-OCT in clinically healthy skin of female patients with breast cancer diagnosis, subsequently treated with RT and compared with a case-control group.…”

Applications and future directions for optical coherence tomography in dermatology*

“…Angiographic OCT in particular has the potential for monitoring of treatment efficacy and disease activity. For example, OCT has been used to monitor the response of patients with severe eczema to dupilumab 67 and (in a single case report) the response of patients with psoriasis to secukinumab 68 …”

“…66 Angiographic OCT in particular has the potential for monitoring of treatment efficacy and disease activity. For example, OCT has been used to monitor the response of patients with severe eczema to dupilumab 67 and (in a single case report) the response of patients with psoriasis to secukinumab. 68 Other inflammatory dermatoses investigated with angiographic OCT include acne, 69 rosacea 70 (where the superficial blood vessels are dilated), 70,71 dermatomyositis and scleroderma (in which the dermis exhibits increased density with loss of cutaneous appendages).…”