Non-invasive imaging of mid-dermal elastolysis

Abstract

Mid-dermal elastolysis (MDE) is a rare disease that is characterized histopathologically by selective loss of elastic tissue in the mid dermis. We aimed to assess MDE using noninvasive skin imaging techniques in vivo. We examined both the lesional and adjacent healthy skin of a woman with the reticular variant of MDE, using confocal scanning laser microscopy, optical coherence tomography (OCT) and high-frequency ultrasound (HFUS). The median diameter of blood vessels at the top of dermal papillae was significantly increased in erythematous lesional skin compared with healthy skin. The mid-dermal signal intensity detected by OCT was higher in healthy skin than in lesional skin. With HFUS, mid-dermal density values were significantly higher in healthy skin than in lesional skin. Our preliminary findings indicate that noninvasive skin imaging methods such as OCT and HFUS might be suitable techniques for the evaluation and monitoring of elastolytic skin disorders such as MDE.

In vivoreflectance-mode confocal microscopy assessments: impact of overweight on human skin microcirculation and histomorphology

“…However, it should be emphasized that the design of the present study does not evaluate variables that may explain the relationship among these parameters. Moreover, the evaluated data of lean controls in this study are in accordance with previous reports on RCM measurements concerning skin microcirculation 27 and skin morphometry. 28 In conclusion, impaired local microvascular function along with histomorphological remodeling of the human skin was evaluated in overweight.…”

Mid-dermal elastolysis: A female-centric disease; case report and updated review of the literature

“…Since Gambichler’s review in 2010, there have been 13 new publications regarding MDE, but these cover only 10 novel clinical cases, as Gambichler and colleagues wrote three distinct publications all regarding the same clinical patient (Gambichler and Skrygan, 2013, Gambichler et al, 2010, Scola et al, 2011). Furthermore, there were two publications on MDE that did not report new clinical cases (El-Khoury et al, 2014, Tong et al, 2013).…”

“…Noninvasive imaging methods, such as coherence tomography and high frequency ultrasound, are potential new modalities recently reported to be of use in evaluating MDE (Scola et al, 2011). Further, multiphoton microscopy, which uses near-infrared light to visualize deep tissues and exploit autofluorescent extracellular matrix fibers, has been used to calculate and three-dimensionally quantify elastic fibers (Tong et al, 2013).…”

“…Fibrillar collagen and elastin are two of the most abundant extracellular matrix constituents, which maintain the structure of the skin (Scola et al, 2011). The density and spatial alignment of the collagen and elastin architecture define the mechanical tissue properties of the skin, namely laxity, stiffness, and porosity.…”

The Application of Ultra-High-Frequency Ultrasound in Dermatology and Wound Management

“…The studies retrieved from the literature report on a wide variety of pathologic conditions of the skin. Overall, 8 studies described cutaneous diseases, 15,18,19,24,26,29,31,32 3 studies reported on cutaneous manifestations in course of systemic diseases, 17,28,34 and 7 studies described UHFUS aspect of malignant lesions. 13,16,[20][21][22]27,33 Chen et al 15 differentiated lichen sclerosus et atrophicus from morphea trough UHFUS examination, as the UHFUS finding of a hypoechoic band corresponding to the presence of severe lymphedema oriented the diagnosis.…”