The knowledge of epidermal thickness (ET) is of great significance in many areas of medical and biological research.
We aimed to assess optical coherence tomography (OCT) in terms of precision, and ...to investigate the influence of several constitutional factors, such as age, gender, skin type, and anatomic site, on the mean ET using OCT in vivo.
Eighty-three subjects were studied using OCT in vivo. Intra- and inter-day repeatability measurements were performed. The mean ET was assessed in six different body sites of young (20–40 years old) and old (60–80 years old) Caucasians, respectively. An ethnic group was included into the study.
OCT proved to be a precise technique in terms of repeatability and reproducibility as expressed in low coefficients of variation. Comparison of young and old Caucasians demonstrated a significant decrease of ET with age in all anatomic sites investigated. ET assessed in males and females did not significantly differ, except for forehead skin which is significantly thinner in old females than in males. ET observed in Caucasians did not significantly differ from ET measured in ethnic individuals. Anatomic sites insignificantly influenced ET on an inter-individual level. However, differences of ET between body sites on an intra-individual level are significant.
This was the first systematic in vivo study on ET investigating several influencing parameters of the epidermal dimension in a reasonable study sample by means of OCT. The results presented here may serve as ET reference data in a variety of clinical and experimental matters.
Abstract MicroRNAs (miRNAs) are very small endogenous RNA molecules about 22–25 nucleotides in length, capable of post-transcriptional gene regulation. miRNAs bind to their target messenger RNAs ...(mRNAs), leading to cleavage or suppression of target mRNA translation based on the degree of complementarity. miRNAs have recently been shown to play pivotal roles in diverse developmental and cellular processes and linked to a variety of skin diseases and cancers. Disruption of miRNA metabolism is also involved in wound healing and inflammatory skin conditions. Here, we review the role of miRNAs in cutaneous biology.
Histology represents the gold standard for morphological investigation of the skin, though biopsy may alter the original morphology, is non-repeatable on the same site and always requires an ...iatrogenic trauma. In the past decade, advances in optics, fibre as well as laser technology have enabled the development of a novel non-invasive optical biomedical imaging technique, optical coherence tomography (OCT). The latter is based on a classic optical measurement method known as low-coherence interferometry that enables non-invasive, high resolution, two- or three-dimensional, cross-sectional imaging of microstructural morphology in biological tissue in situ. Using conventional OCT with a lateral resolution of 10–15
μm, the stratum corneum of glabrous skin (palmoplantar), the epidermis and the upper dermis can usually be identified, as well as skin appendages and blood vessels. For example, non-invasive monitoring of cutaneous inflammation, hyperkeratotic conditions and photoadaptive processes is possible by means of OCT. Furthermore, the development of high-output broadband light sources, e.g. femtosecond Ti:sapphire laser, might soon enable ultrahigh image resolutions of about 1
μm in order to investigate skin tissue on the cellular level, which could potentially allow the differentiation between benign and malignant tissues. Beyond a high resolution morphology in OCT images, tissue characterization by additional local physical parameters, such as the scattering coefficient and refractive index may be of great value, in particular in cosmetics and the pharmaceutical industry. Functional OCT imaging based on spectroscopy, tissue birefringence, elastography and Doppler flow reveals further information on tissue properties and represents an important progress of OCT technique in the field of dermatology. Therefore, the advanced versions of OCT technique might not only lead to significant new insights in skin physiology and pathology, but also in diagnosis and therapeutic control of cutaneous disorders with respect to non-invasive diagnosis of conditions and monitoring of disease activity in addition to treatment effects over time.
Abstract Background MicroRNAs (miRNAs) are a novel class of short RNAs that are capable epigenetically regulating gene expression in eukaryotes. MicroRNAs have been shown to be dysregulated in a ...variety of cancers. The data on miRNA expression in cutaneous squamous cell carcinoma (cSCC) are very limited, and microarray-based miRNA expression profiles of cSCC have not yet been determined. Objective To describe differentially expressed miRNAs in cSCC. Methods Seven patients with cSCC were enrolled in the present study. Tumor biopsies ( n = 7) were taken from the center of each tumor. Adjacent healthy skin ( n = 7) was biopsied as a control (intraindividual control). miRNA expression profiles of all specimens were detected by microarray miRNA expression profiling based on miRBAse 16 scanning for 1205 potential human miRNA target sequences. The microarray results were confirmed by TaqMan quantitative real-time polymerase chain reaction (qRT-PCR). Results Non-stringent filtering with a non-adjusted p ≤ 0.05 revealed thirteen up-regulated and eighteen down-regulated miRNAs. Non-stringent filtering with a non-adjusted p ≤ 0.01 revealed three up-regulated (hsa-miR-135b, hsa-miR-424 and hsa-miR-766) and six down-regulated (hsa-miR-30a*, hsa-miR-378, hsa-miR-145, hsa-miR-140-3p, hsa-miR-30a and hsa-miR-26a) miRNAs in cSCC. Conclusion This study reveals differentially expressed miRNAs that may play a role in the molecular pathogenesis of cSCC and that are excellent candidates for further validation and functional analysis.
Perturbations in microRNA (miRNA) expression profiles have been reported for cutaneous malignant melanoma (CMM) predominantly when examined in cell lines. Despite the rapidly growing number of newly ...discovered human miRNA sequences, the availability of up-to-date miRNA expression profiles for clinical samples of primary cutaneous malignant melanoma (PCMM), cutaneous malignant melanoma metastases (CMMM), and benign melanocytic nevi (BMN) is limited. Specimens excised from the center of tumors (lesional) from patients with PCMM (n=9), CMMM (n=4), or BMN (n=8) were obtained during surgery. An exploratory microarray analysis was performed by miRNA expression profiling based on Agilent platform screening for 1205 human miRNAs. The results from the microarray analysis were validated by TaqMan quantitative real-time polymerase chain reaction. In addition to several miRNAs previously known to be associated with CMM, 19 unidentified miRNA candidates were found to be dysregulated in CMM patient samples. Among the 19 novel miRNA candidates, the genes hsa-miR-22, hsa-miR-130b, hsa-miR-146b-5p, hsa-miR-223, hsa-miR-301a, hsa-miR-484, hsa-miR-663, hsa-miR-720, hsa-miR-1260, hsa-miR-1274a, hsa-miR-1274b, hsa-miR-3663-3p, hsa-miR-4281, and hsa-miR-4286 were upregulated, and the genes hsa-miR-24-1*, hsa-miR-26a, hsa-miR-4291, hsa-miR-4317, and hsa-miR-4324 were downregulated. The results of this study partially confirm previous CMM miRNA profiling studies identifying miRNAs that are dysregulated in CMM. However, we report several novel miRNA candidates in CMM tumors; these miRNA sequences require further validation and functional analysis to evaluate whether they play a role in the pathogenesis of CMM.
Background The coexistence of lichen sclerosus (LiS) and localized scleroderma (LoS) has sporadically been reported in the literature. Recently, a prospective multicenter study demonstrated a ...surprisingly high percentage of genital LiS in patients with morphea. Objective The aim of this study was to determine the prevalence of LiS in a cohort of patients with LoS who presented at a tertiary referral medical center for connective tissue diseases in Germany. Methods We retrospectively evaluated the prevalence of genital and extragenital LiS in adult and pediatric patients with different subtypes of LoS. Secondary outcome measures included demographic characteristics and prevalence of other concomitant autoimmune diseases. Results Of the 472 patients (381 adults, 91 children; mean age: 46 years; range, 4-88 years; female to male ratio: 3.5:1 in adults and 8:1 in children) with LoS, 27 (5.7%) also presented with LiS (19 extragenital and 8 genital lesions). LiS exclusively occurred in patients with plaque-type (morphea) and generalized LoS. Twenty-six of the 27 (96.2%) patients with concomitant LoS and LiS were adults. Compared with LiS in the general population, LiS was significantly more frequent in LoS as indicated by an odds ratio of 18.1 (95% confidence interval 2.6-134.2; P < .0001). In all, 38 (8.1%) patients with LoS had other autoimmune disorders (most frequently Hashimoto thyroiditis, rheumatoid arthritis, and alopecia areata). Limitations This was a retrospective study. Conclusions This large retrospective analysis confirms recent reports of a high prevalence of LiS in patients with LoS. Based on these findings, patients with LoS, especially those with morphea, should be carefully screened for concomitant LiS, including inspection of the anogenital region.
In previous trials, UV therapy has been demonstrated to be effective in the treatment of localized scleroderma (LS). To date, a randomized comparison study to evaluate the efficacy and safety of ...different, commonly used phototherapeutic modalities in LS is still outstanding.
The aim of this study was to compare the safety and efficacy of low-dose (LD) UVA1, medium-dose (MD) UVA1, and narrowband (NB) UVB phototherapy in the treatment of LS.
Sixty four patients with LS were consecutively included in a prospective, open, randomized controlled 3-arm study. Severity of LS was determined by means of a clinical score, and clinical improvement was also monitored by histopathologic analysis and 20-MHz ultrasound.
A total of 27 patients were treated with LD UVA1 (20 J/cm
2), 18 patients received MD UVA1 (50 J/cm
2), and 19 patients were treated with NB UVB dependent on their skin type. Phototherapy was performed 5 times weekly for 8 weeks. Two of the 64 patients included in this trial discontinued therapy. Skin status significantly improved in all patients who finished the treatment protocol, resulting in a reduction of the clinical score in all groups (LD UVA1, 7.6-5.0
P < .001, 95% confidence interval 1.6-3.4; MD UVA1, 11.1-6.6
P < .001, 95% confidence interval 2.5-6.2; NB UVB, 7.3-4.9
P < .001, 95% confidence interval 1.6-3.2). The reduction of the score was accompanied by an improvement of the visual analog scale for itching and tightness, histologic score, and 20-MHz ultrasound. MD UVA1 was significantly more effective than NB UVB (
P < .05). There were no significant differences between LD UVA1 and NB UVB and the former and MD UVA1 (
P > .05).
We had a relatively small study sample and nonblinded assessment of primary outcome.
Phototherapy, as previously reported in several noncontrolled trials, is an effective therapeutic option in LS, with a favorable risk/benefit ratio. UVA1 phototherapy should be considered among the first approaches in the management of LS.
Background Although optical coherence tomography (OCT) is a promising noninvasive imaging technique for the micromorphology of the skin, OCT has not been studied systematically in skin cancer such as ...malignant melanoma (MM). Objective We sought to visualize and characterize melanocytic skin lesions (MSL) by using OCT in vivo, compare OCT features of benign nevi (BN) and MM, and histologically validate the OCT findings. Methods In all, 75 patients with 92 MSL, including 52 BN and 40 MM, were included in this study. MSL were investigated by OCT in vivo and consecutive histology. We compared the OCT images with the corresponding histologic slices of BN and MM. To ascertain accuracy of correlation between OCT images and histologic sections, the excised lesions were tattooed according to the level of OCT scanning. For every MSL, serial histologic slices were prepared. Results MM often showed a marked architectural disarray ( P = .036) and rarely displayed a clear dermoepidermal border ( P = .0031) when compared with BN. OCT of MM infrequently demonstrated a dermoepidermal junction zone with finger-shaped elongated rete ridges as typically seen in BN ( P = .011). Compared with BN, the papillary and superficial reticular dermis in MM frequently displayed a more diffuse or patchy reflectivity with loss of the typical bright horizontal linear structures ( P = .022). However, more or less large vertical, icicle-shaped structures were the most striking OCT feature of MM, which were not observed in BN ( P < .001). Limitations The diagnostic performance of OCT in the diagnosis of MSL could not be fully determined. Sensitivity and specificity studies also including other skin tumors have not been performed. Conclusion In this study, distinct OCT features of MSL could be correlated to histopathologic findings. With regard to the micromorphologic features visualized by OCT, we detected significant differences between BN and MM. These OCT features might serve as useful discriminating parameters of MSL.
Summary Background Optical coherence tomography (OCT) is a promising non-invasive imaging technique that has not systematically been studied in skin cancer such as basal cell carcinoma (BCC). ...Objective We aimed, first, to describe the in vivo histologic features of BCC by using OCT, and second, to find out whether it is possible to differentiate BCC subtypes by means of OCT. Methods Prior to the excision, the BCCs ( n = 43) as well as adjacent non-lesional skin sites were assessed by OCT in vivo. The lesional area of interest was marked prior to OCT and tattooed after excision, respectively, in order to enable topographical concordance between the cross-sectional OCT images and the histologic sections. Results Compared to non-lesional skin, a loss of normal skin architecture and disarrangement of the epidermis and upper dermis was observed in the OCT images of BCCs. Features that were frequently identified by OCT and correlated with histology included large plug-like signal-intense structures, honeycomb-like signal-free structures, and prominent signal free cavities in the upper dermis. With regard to the aforementioned OCT features, no statistically significant ( P < 0.05) difference was found between nodular, multifocal superficial, and infiltrative BCCs, respectively. Conclusions OCT is capable to visualize altered skin architecture and histopathological correlates of BCC. However, there is not at this time sufficient data supporting the clinical use of OCT for the differentiation of BCC subtypes.
