Morphologic Features of Melanocytes, Pigmented Keratinocytes, and Melanophages by In Vivo Confocal Scanning Laser Microscopy

Abstract

Confocal scanning laser microscopy (CSLM) represents a novel imaging technique for in vivo microscopic analysis of skin lesions at a level of resolution that allows morphologic analysis of microanatomic structures. We investigated the feasibility of recognizing the cellular constituents of pigmented skin lesions, such as pigmented keratinocytes, melanocytes, and melanophages, by CSLM. Fifteen pigmented lesions (five pigmented seborrheic keratoses, and 10 compound melanocytic nevi) from 15 patients were studied, as well as normal skin. After the clinical lesions were imaged by CSLM, they were biopsied or excised for examination by conventional histology for comparison of the morphologic features. In images obtained by CSLM, pigmented keratinocytes were seen as polygonal cohesive cells with variably bright granular cytoplasm. Melanocytes appeared as bright round, oval, fusiform, or dendritic cells. The architectural growth pattern of melanocytes could be analyzed. Melanocytes were identified by their nested growth pattern as aggregates of bright round to oval structures at the dermoepidermal junction or in the superficial dermis. Melanocytes were also recognizable as single cells along the dermoepidermal junction, usually separated from each other by a variable number of keratinocytes. Melanophages appeared as large bright plump cells with ill-defined cytoplasmic borders, usually located around or near vessels of the superficial dermis. Our results demonstrate that the cellular constituents of pigmented lesions can be recognized by CSLM. This technique sets a new paradigm for noninvasive quasihistologic examination of pigmented lesions in vivo and merits further evaluation for diagnostic use.

In vivo assessment of melanocytic nests in nevi and melanomas by reflectance confocal microscopy

“…Characteristic RCSLM features concerning melanocytes, pigmented keratinocytes and melanophages have been reported. 9 Moreover, some RCSLM aspects, such as the disarray of the normal honeycombed architecture of the stratum spinosum, the presence of polymorph reflecting cells in the basal cell layers, sometimes spreading upwards in pagetoid fashion, and the presence of dendritic-like structures in superficial layers in lentigo maligna melanomas, appeared to be useful for the distinction between melanocytic nevi and melanomas. 10,12,13 Although the presence of cell clusters forming nests was previously reported in melanocytic nevi and in lentigo maligna, 9,10,13 they were not described in melanomas and Spitz nevi.…”

“…[9][10][11][12][13][14][15][16][17] Some RCSLM features of melanocytic lesions have been recently identified. [10][11][12][13] Studying four melanomas, two lentigo maligna melanomas and 34 melanocytic nevi, distinct cytological features were found at the RCSLM observation.…”

“…[10][11][12][13] Studying four melanomas, two lentigo maligna melanomas and 34 melanocytic nevi, distinct cytological features were found at the RCSLM observation. 10 The presence of cells clustered into nests was reported in melanocytic nevi 9,10 and in lentigo maligna, 13 but not described in details.…”

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“…Since then, there has been many studies evaluating its role in viewing the microscopic features of normal skin [9] and various lesions such as cutaneous neoplasms [10,11], pigmented lesions [12,13,14], actinic keratosis [15], sebaceous gland hyperplasia [16], psoriasis [17], irritant and allergic contact dermatitis [18,19]. CLSM can distinguish melanocytes from other pigmented lesions like pigmented J Cancer Res Therap Oncol 2015 | Vol 3: 104 keratinocytes and melanophages [20]. Typical CLSM has a lateral resolution of 0.5-1µm and axial resolution of 3-5 µm providing horizontal sections similar to thickness of histology sections.…”

Caracterização da pele fotoenvelhecida, desenvolvimento e eficácia clínica de formulações dermocosméticas por técnicas de biofísica e análise de imagem

“…A Microscopia tem sido uma técnica de análise muito utilizada na ciência, e Além disso, era indiscutível a vantagem de avaliar alterações ao longo do tempo em um mesmo local, tecido, e então, esta tecnologia foi considerada um "novo paradigma na microscopia" (JESTER et al, 1991 (AGOZZINO et al, 2011;BUSAM et al, 2001;GONZÁLEZ et al, 2003;PELLACANI et al, 2008).…”