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Ramani RS, Tan I, Bussau L, Angel CM, McCullough M, Yap T. Confocal microscopy in oral cancer and oral potentially malignant disorders: A systematic review. Oral Dis 2023; 29:3003-3015. [PMID: 35765235 DOI: 10.1111/odi.14291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/12/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To systematically identify and summarise current research on the utility of confocal microscopy in oral squamous cell carcinoma and oral epithelial dysplasia in oral potentially malignant disorders. METHODS Databases Medline, Embase, Evidence-Based Medicine, and Web of Science were searched with articles screened and included if their primary objective was the use of a confocal microscope in diagnosis of oral cancer or epithelial dysplasia, in vivo or ex vivo. RESULTS AND DISCUSSION Twenty-eight relevant studies were identified of which 21 studies included oral squamous cell carcinoma specimens. Fifteen studies included in vivo use. The studies included both qualitative and fluorescence confocal microscope and reflectance confocal microscope analysis along with quantitative analysis of carcinoma and dysplasia. Thirteen studies reported the predictive value of their confocal device in the diagnosis of dysplasia and carcinoma. The quantitative software-based studies show promise in objectifying the diagnostic process for identifying abnormalities within the microstructure of the oral mucosa. CONCLUSIONS There was heterogeneity in the criteria for diagnosis of dysplasia and oral squamous cell carcinoma with experience levels of assessors impacting method efficacy. Both qualitative and quantitative confocal assessment methodologies have been explored, the latter highlighting the potential of future machine-augmented diagnostic precision.
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Affiliation(s)
| | - Ivy Tan
- Melbourne Dental School, Melbourne, Victoria, Australia
| | | | | | | | - Tami Yap
- Melbourne Dental School, Melbourne, Victoria, Australia
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2
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Caruntu C, Tsatsakis AM, Tampa M, Georgescu SR, Gonzalez S. Editorial: Recent advances in keratinocyte carcinomas: From molecular mechanisms to clinical perspectives. Front Med (Lausanne) 2022; 9:1078020. [DOI: 10.3389/fmed.2022.1078020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
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The Role of Reflectance Confocal Microscopy in the Evaluation of Pigmented Oral Lesions and Their Relationship With Histopathological Aspects. Am J Dermatopathol 2022; 44:658-663. [PMID: 35503878 DOI: 10.1097/dad.0000000000002220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Oral pigmentations are a heterogeneous group and can be the result of physiological activity of oral mucosal melanocytes, secondary to exogenous causes, associated with systemic or local diseases, or due to proliferative activity of melanocytes. Their diagnosis is critical because these lesions can be markers of internal diseases or, in the case of melanocytic proliferative processes, they may represent a malignant neoplasm. In the past decade, the use of reflectance confocal microscopy, a noninvasive imaging tool, has aided the analysis of such lesions, but the establishment of firm criteria in their evaluation is still lacking. This study evaluated a series of 19 cases of pigmented oral lesions and correlated the reflectance confocal microscopy findings with histopathological classical criteria. We found 13 cases of melanotic macule, 1 of them associated with Peutz-Jeghers syndrome and 2 with Laugier-Hunzinker syndrome; 1 melanocytic nevus; 2 lentigo maligna; 2 pigmented actinic cheilitis; and 1 case of postinflammatory pigmentation secondary to a lupus erythematosus oral discoid lesion. The main difference between benign and malignant lesions was the presence of atypical proliferation in lentigo maligna. Langerhans cells with thick dendritic processes, which may be present in other benign and inflammatory pigmentations is one of the main reasons for diagnostic pitfalls.
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Vasilovici A, Ungureanu L, Grigore L, Cojocaru E, Şenilă S. Actinic Cheilitis - From Risk Factors to Therapy. Front Med (Lausanne) 2022; 9:805425. [PMID: 35242781 PMCID: PMC8886241 DOI: 10.3389/fmed.2022.805425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022] Open
Abstract
Actinic cheilitis or solar cheilosis is considered a precursor of malignancy or even an in situ squamous cell carcinoma (SCC) of the lip, located most frequently on the lower lip. Actinic cheilitis (AC) has a higher likelihood of developing into invasive SCC of the lip, which is one of the deadliest non-melanoma skin cancers. Risk factors include chronic UV exposure, increasing age, male gender, fair phototypes, chronic scarring, immunosuppressive therapy, and tobacco use. From a clinical point of view, AC is characterized by dryness, scaling, atrophy, indistinct borders, and erosions. Ulceration and the appearance of a nodule often suggest the progression to invasive SCC. Dermoscopic examination reveals white structureless areas, scales, erosions, and white halos of the vermilion. Reflectance confocal microscopy shows disruption of the stratum corneum, parakeratosis, an atypical honeycomb pattern, solar elastosis, and dilated and tortuous blood vessels with increased blood flow. The rate of malignant transformation ranges from 10 to 30% and early diagnoses and treatment are essential in preventing the development of invasive SCC. Optimal treatment has not been established yet, but invasive and topical treatments can be tried. The present paper aims to review the existing data regarding epidemiology, risk factors, clinical picture, non-invasive imaging, diagnosis, and therapy in AC.
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Affiliation(s)
- Alina Vasilovici
- Department of Dermatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Dermatology, Cluj-Napoca Emergency County Hospital, Cluj-Napoca, Romania
| | - Loredana Ungureanu
- Department of Dermatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Dermatology, Cluj-Napoca Emergency County Hospital, Cluj-Napoca, Romania
| | - Lavinia Grigore
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Carola Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Dermatology, Municipal Clinical Hospital, Cluj-Napoca, Romania
| | - Elena Cojocaru
- Department of Dermatology, Oradea Emergency County Hospital, Oradea, Romania
| | - Simona Şenilă
- Department of Dermatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Dermatology, Cluj-Napoca Emergency County Hospital, Cluj-Napoca, Romania
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5
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Zhang MY, Jiang WW. In vivo reflectance confocal microscopy diagnostic features of actinic cheilitis: a retrospective case series. J Eur Acad Dermatol Venereol 2022; 36:e545-e548. [PMID: 35181949 DOI: 10.1111/jdv.18018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/17/2022] [Accepted: 02/15/2022] [Indexed: 11/29/2022]
Affiliation(s)
- M Y Zhang
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.,College of Stomatology, Shanghai Jiao Tong University.,National Center for Stomatology.,National Clinical Research Center for Oral Diseases.,Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011
| | - W W Jiang
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.,College of Stomatology, Shanghai Jiao Tong University.,National Center for Stomatology.,National Clinical Research Center for Oral Diseases.,Shanghai Key Laboratory of Stomatology, Shanghai, China, 200011
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6
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Reflectance confocal microscopy (RCM)-based criteria for progression of lower-lip squamous cell carcinoma: A prospective study. Oral Oncol 2022; 125:105674. [DOI: 10.1016/j.oraloncology.2021.105674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 11/29/2021] [Accepted: 12/11/2021] [Indexed: 01/10/2023]
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7
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Romano A, Di Stasio D, Petruzzi M, Fiori F, Lajolo C, Santarelli A, Lucchese A, Serpico R, Contaldo M. Noninvasive Imaging Methods to Improve the Diagnosis of Oral Carcinoma and Its Precursors: State of the Art and Proposal of a Three-Step Diagnostic Process. Cancers (Basel) 2021; 13:cancers13122864. [PMID: 34201237 PMCID: PMC8228647 DOI: 10.3390/cancers13122864] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Oral squamous cell carcinoma (OSCC) accounts for 90–95% of malignant tumors of the lip and oral cavity and is associated with high mortality in the advanced stages. Early diagnosis is a challenge for oral pathologists and dentists, due to the ambiguous appearance of early OSCC, which is often misdiagnosed, mistreated, and associated with diagnostic delay. The gold standards for OSCC diagnosis are biopsy and histopathological assessment, but these procedures are invasive and time-consuming. Adjunctive noninvasive techniques allow the definition of the malignant features of a suspicious lesion in real time and noninvasively, thus improving the diagnostic procedure. The present review aimed to focus on some of the main promising noninvasive imaging techniques, to highlight their perspective adoption in a three-step diagnosis, which is idealistically faster and better, as well as enables the patient’s compliance. Abstract Oral squamous cell carcinoma (OSCC) is the most prevalent form of cancer of lips and oral cavity, and its diagnostic delay, caused by misdiagnosis at the early stages, is responsible for high mortality ratios. Biopsy and histopathological assessment are the gold standards for OSCC diagnosis, but they are time-consuming, invasive, and do not always enable the patient’s compliance, mainly in cases of follow-up with the need for more biopsies. The use of adjunctive noninvasive imaging techniques improves the diagnostic approach, making it faster and better accepted by patients. The present review aims to focus on the most consolidated diagnostic techniques, such as vital staining and tissue autofluorescence, and to report the potential role of some of the most promising innovative techniques, such as narrow-band imaging, high-frequency ultrasounds, optical coherence tomography, and in vivo confocal microscopy. According to their contribution to OSCC diagnosis, an ideal three-step diagnostic procedure is proposed, to make the diagnostic path faster, better, and more accurate.
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Affiliation(s)
- Antonio Romano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy;
| | - Fausto Fiori
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Carlo Lajolo
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli–IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy;
| | - Andrea Santarelli
- Department of Clinical Specialist and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy;
| | - Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
- Correspondence: ; Tel.: +39-3204876058
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Garofalo V, Cannarozzo G, Del Duca E, Sannino M, Mazzilli S, Dattola A, Nisticò SP, Campione E, Bianchi L. Combination of Laser Therapy and Photodynamic Therapy with 5-Aminolevulinic Acid Patch for the Treatment of Actinic Cheilitis. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:303-307. [PMID: 33844608 DOI: 10.1089/photob.2020.4853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Actinic cheilitis (AC) is a premalignant lesion of the lips that can evolve into squamous cell carcinoma. Among nonsurgical treatments, photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) patch might represent a new noninvasive therapeutic approach for AC. Objective: We sought to investigate the potential role of fractional CO2 laser pretreatment in boosting ALA penetration and distribution into AC treated with PDT. Methods: We report a case of a woman with AC on the lower lip, treated with ablative fractional CO2 laser to boost drug delivery of 5-ALA patch before PDT treatment. Reflectance confocal microscopy was performed to assess diagnosis and treatment response. Results: We detected a good clinical and cosmetic outcome after two applications of combined treatment. Erythema, crust, and edema were reported as side effects. Conclusions: This case report shows that ablative fractional CO2 laser-assisted PDT might be an effective therapeutic alternative for patients with AC who refuse or are contraindicated for surgical procedures.
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Affiliation(s)
- Virginia Garofalo
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | | | - Ester Del Duca
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Mario Sannino
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Sara Mazzilli
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | | | | | - Elena Campione
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
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Lupu M, Caruntu A, Boda D, Caruntu C. In Vivo Reflectance Confocal Microscopy-Diagnostic Criteria for Actinic Cheilitis and Squamous Cell Carcinoma of the Lip. J Clin Med 2020; 9:jcm9061987. [PMID: 32630380 PMCID: PMC7356181 DOI: 10.3390/jcm9061987] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/11/2020] [Accepted: 06/24/2020] [Indexed: 12/21/2022] Open
Abstract
Actinic cheilitis (AC) is one of the most frequent pathologies to affect the lips. Studies show that the most commonplace oral malignancy, squamous cell carcinoma (SCC), often emerges from AC lesions. Invasive diagnostic techniques performed on the lips carry a high risk of complications, but reflectance confocal microscopy (RCM), a non-invasive skin imaging technique, may change the current diagnostic pathway. This retrospective study was aimed at consolidating the RCM diagnostic criteria for AC and lip SCC. The study was conducted in two tertiary care centers in Bucharest, Romania. We included adults with histopathologically confirmed AC and SCC who also underwent RCM examination. Of the twelve lesions included in the study, four were AC and eight were SCC. An atypical honeycomb pattern and the presence of target cells in the epidermis were RCM features associated with AC. SCC was typified by the presence of complete disruption of the epidermal architecture and dermal inflammatory infiltrates. The mean blood vessel diameter in SCC was 18.55 µm larger than that in AC (p = 0.006) and there was no significant difference (p = 0.64) in blood vessel density, as measured by RCM, between SCC and AC. These data confirm that RCM can be useful for the in vivo distinction between AC and lip SCC.
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Affiliation(s)
- Mihai Lupu
- Dermatology Research Laboratory, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.L.); (D.B.)
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania
- Faculty of Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
- Correspondence: ; Tel.: +40-72-2345-344
| | - Daniel Boda
- Dermatology Research Laboratory, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.L.); (D.B.)
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania;
| | - Constantin Caruntu
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania;
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Gonzaga AKG, Mafra RP, da Silva LP, de Almeida Freitas R, de Souza LB, Pinto LP. Actinic cheilitis: Morphometric parameters and its relationship with the degree of epithelial dysplasia. Acta Histochem 2020; 122:151452. [PMID: 31558280 DOI: 10.1016/j.acthis.2019.151452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 12/31/2022]
Abstract
Actinic cheilitis (AC) is a potentially malignant lesion caused by chronic sun exposure. This study aimed to evaluate the relationship between the degree of epithelial dysplasia and morphometric findings in AC. Sixty-eight slides of AC cases were selected and classified according to the grade of epithelial dysplasia, following morphologic criteria of World Health Organization. For morphometric analysis, the slides were scanned and images were analyzed using Pannoramic Viewer software. We obtained vertical measurements of the parameters: thicknesses of the keratin layer, lamina propria and zone of solar elastosis in three selected fields. Thirty-seven (54.4%) of the analyzed cases were classified as none/mild dysplasia and 31 (45.6%) as moderate/severe epithelial dysplasia. Cases with a moderate/severe dysplasia exhibited a thicker layer of keratin (median = 0.055 mm) than none/mild dysplasia (median = 0.045 mm) (p = 0.033). No significant differences in the thicknesses of lamina propria and zone of solar elastosis were observed according to the grade of epithelial dysplasia. A positive significant correlation between keratin layer and lamina propria thicknesses was found (p = 0.019). Based on our findings, rigorous clinical follow-up should be recommended for patients whose histopathological examination shows a greater thickness of the keratin layer.
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11
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Lupu M, Caruntu A, Caruntu C, Boda D, Moraru L, Voiculescu V, Bastian A. Non-invasive imaging of actinic cheilitis and squamous cell carcinoma of the lip. Mol Clin Oncol 2018; 8:640-646. [PMID: 29725529 PMCID: PMC5920479 DOI: 10.3892/mco.2018.1599] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/22/2018] [Indexed: 01/20/2023] Open
Abstract
An early diagnosis is of overwhelming importance for the management and prognosis of mucocutaneous cancer. Actinic cheilitis (AC), defined by the clonal expansion of genomically unstable keratinocytes, is the most common potentially malignant lesion affecting the lips. Squamous cell carcinoma (SCC) is the most frequent oral malignancy, and there is strong evidence that the majority of the SCCs of the lip originate from AC. There is considerable difficulty in discerning between dysplasia and invasive carcinomas solely on a clinical basis. Although dermoscopy has become an essential tool for skin tumor evaluation, reflectance confocal microscopy (RCM) is a non-invasive imaging technology that has proved itself extremely useful in the diagnosis and monitoring of several skin diseases, including AC and SCC. The present study aimed to re-emphasize the usefulness of RCM in the early detection of malignant transformation, using AC and SCC of the lips as working examples. Due to the apparent innocuousness of AC for numerous patients, it is not possible to overstress the importance of a correct and early diagnosis, proper treatment and long-term patient follow-up as being essential for preventing the progression to lip SCC, or for its timely diagnosis.
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Affiliation(s)
- Mihai Lupu
- Department of Dermatology, MEDAS Medical Center, Bucharest 030442, Romania
| | - Ana Caruntu
- ‘Carol Davila’ Central Military Emergency Hospital, Bucharest 010825, Romania
- ‘Titu Maiorescu’ University, Faculty of Medicine, Bucharest 031593, Romania
| | - Constantin Caruntu
- Department of Physiology, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 050474, Romania
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest 011233, Romania
| | - Daniel Boda
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 050474, Romania
- Carol Medical Center, Bucharest 010626, Romania
| | - Liliana Moraru
- ‘Carol Davila’ Central Military Emergency Hospital, Bucharest 010825, Romania
| | - Vlad Voiculescu
- Department of Dermatology and Allergology, Elias Emergency University Hospital, Bucharest 011461, Romania
| | - Alexandra Bastian
- Department of Pathology, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 050474, Romania
- Department of Pathology, ‘Colentina’ University Hospital, Bucharest 020125, Romania
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12
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Gonzaga AKG, de Oliveira PT, da Silveira ÉJD, Queiroz LMG, de Medeiros AMC. Diclofenac sodium gel therapy as an alternative to actinic cheilitis. Clin Oral Investig 2017; 22:1319-1325. [PMID: 28986686 DOI: 10.1007/s00784-017-2237-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/29/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Actinic cheilitis (AC) is a potentially malignant lesion caused by prolonged exposure to ultraviolet light. The aim of this research was to analyze the efficacy of diclofenac sodium 3% gel in the treatment of this condition, through clinical follow-up. METHODS Thirty-one patients diagnosed with AC were instructed to perform a topical application of the gel three times a day for a period of 90 days. In each visit, a digital photography was obtained for verified progress and response to treatment. Two researchers evaluated all images after treatment was completed and assigned the following scores regarding clinical aspect of the lip: 1, complete improvement; 2, partial improvement; 3, no changes; 4, worsening of the clinical condition. In addition, the patients' tolerability to the drug and their satisfaction after treatment were evaluated. RESULTS Twelve cases abandoned the treatment for reasons unrelated to the study. Ten participants showed total remission of all clinical features of the lesion and three had partial improvement of the characteristics. One participant presented worsening of clinical condition, and in five cases, treatment was discontinued due to development of mild adverse effects at the site of gel application. Regarding satisfaction analyses and tolerability to the drug, from 14 patients who completed treatment without adverse effects or complications, most agreed fully that they were satisfied with the therapy (n = 11) and that the drug was not irritating to the mouth (n = 9). Patients are being monitored without clinical signs of recurrence and/or progression of the lesions. CONCLUSION Topical application of the drug has provided a convenient and well tolerated in most cases. CLINICAL RELEVANCE Diclofenac sodium gel (3%) may be a promising alternative for treatment of actinic cheilitis.
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Affiliation(s)
- Amanda Katarinny Goes Gonzaga
- Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil. .,Department of Dentistry, Universidade Federal do Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil.
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Reflectance confocal microscopic evaluation of nonmelanocytic lip lesions. Lasers Med Sci 2017; 32:1497-1506. [DOI: 10.1007/s10103-017-2270-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 06/18/2017] [Indexed: 10/19/2022]
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14
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Ma YF, Yuan C, Jiang WC, Wang XL, Humbert P. Reflectance confocal microscopy for the evaluation of sensitive skin. Skin Res Technol 2016; 23:227-234. [PMID: 27782310 DOI: 10.1111/srt.12327] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nowadays, the diagnosis for sensitive skin relies on subjective assessment or on the combination of subjective and objective evaluation. No quantitative evaluation is available. It could be expected that confocal microscopy imaging could be of interest to better define the condition. METHODS Total 166 healthy female subjects were recruited in this study. Firstly, all subjects completed the sensitive questionnaire. Then, the cutaneous structures were measured by the reflectance confocal microscopy (RCM) on the face and fossa cubitalia. The lactic acid sting test was conducted finally. According to the results of self-perception sensitive skin questionnaire and lactic acid stinging test to evaluate facial skin sensitivity the both positive subjects were regarded as sensitive skin group and both negative group as healthy control group. RESULT The results of RCM indicating that the proportion of 'disarranged honeycomb pattern' and 'spongiform edema' in the sensitive group and healthy control group were statistically different (P < 0.05), respectively; The following report 'damaged dermal papilla rings' was not a distinctive pattern, with no significant statistical difference (P > 0.05). The epidermal thickness was 38.88 ± 6.81 μm, healthy control group was 40.31 ± 9.37 μm in, respectively, sensitive skin group and healthy control group, there was no significant statistical difference between the two groups (P > 0.05). The honeycomb structure depth of sensitive group was 20.57 ± 4.86 μm. It was for 23.27 ± 6.38 μm, healthy control group the difference being statistically different between the two groups (P < 0.05). CONCLUSION Based on the RCM results, 'epidermal honeycomb structure' and 'spongiform edema' may be used as new skin signs of RCM evaluation of sensitive skin effectively. Indeed, sensitive skin honeycomb structure depth was thinner compared with healthy control group. Such a specific pattern has good clinical and monitoring value for the further exploration. RCM could provide new data and patterns for the evaluation of sensitive skin.
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Affiliation(s)
- Y-F Ma
- Department of Skin and Cosmetic Research, Shanghai Skin Disease Hospital, Shanghai, China
| | - C Yuan
- Department of Skin and Cosmetic Research, Shanghai Skin Disease Hospital, Shanghai, China
| | - W-C Jiang
- Department of Skin and Cosmetic Research, Shanghai Skin Disease Hospital, Shanghai, China
| | - X-L Wang
- Department of Phototherapy, Shanghai Skin Disease Hospital, Shanghai, China
| | - P Humbert
- Research and Studies Center on the Integument (CERT), Department of Dermatology, Clinical Investigation Center (CIC INSERM 1431), Besançon University Hospital, Besançon, France.,INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France
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16
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In vivo reflectance confocal microscopy for evaluating melanoma of the lip and its differential diagnoses. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:84-94. [PMID: 27720652 DOI: 10.1016/j.oooo.2016.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 06/18/2016] [Accepted: 08/11/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To improve prebiopsy diagnostic accuracy and surgical management of pigmented appearing lesions on the lips, particularly melanoma, using in vivo reflectance confocal microscopy (RCM). STUDY DESIGN Prospective case series over a 12-month period between 2015 and 2016. The setting was two specialist dermatology referral centers with expertise in confocal microscopy. The study population was a consecutive sample of patients with pigmentation of the lip for which the cause was uncertain clinically, whose differential diagnosis included melanoma, and who had undergone both in vivo RCM and subsequent biopsy. The outcome measures were RCM features, dermoscopy features, and histopathological diagnosis. Results were reported by descriptive analysis and correlations made between RCM features and histopathology. RESULTS Eight patients were recruited for the study. In vivo RCM facilitated the targeting of small biopsies to identify two in situ oral melanoma recurrences and successfully mapped an in situ oral melanoma before wide excision. Suprabasal dendritic pagetoid cells and epidermal disarray on RCM were useful indicators for in situ melanoma of the lip. Previously described dermoscopy features for mucosal melanoma were not very helpful in diagnosing melanoma in our series. Challenges included evaluating inflamed lesions with pigment incontinence. CONCLUSIONS RCM can assist in the diagnosis and management of pigmented lip lesions, but additional studies are required to further evaluate these initial observations.
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das Chagas E Silva de Carvalho LF, Pereira TM, Magrini TD, Cavalcante ASR, da Silva Martinho H, Almeida JD. Optical diagnosis of actinic cheilitis by infrared spectroscopy. Photodiagnosis Photodyn Ther 2016; 16:27-34. [PMID: 27491855 DOI: 10.1016/j.pdpdt.2016.07.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/28/2016] [Accepted: 07/30/2016] [Indexed: 01/28/2023]
Abstract
Actinic cheilitis (AC) is considered a potentially malignant disorder of the lip. Biomolecular markers study is important to understand malignant transformation into squamous cell carcinoma. Fourier transform infra red (FT-IR) spectroscopy was used to analyze AC in this study. OBJECTIVES The aim of the study was to evaluate if FT-IR spectral regions of nucleic acids and collagen can help in early diagnosis of malignant transformation. METHODS Tissues biopsies of 14 patients diagnosed with AC and 14 normal tissues were obtained. FT-IR spectra were measured at five different points resulting in 70 spectra of each. Analysis of Principal components analysis (PCA) and linear discrimination analysis (LDA) model were also used. In order to verify the statistical difference in the spectra, Mann-Whitney U test was performed in each variable (wavenumber) with p-value <0.05. RESULTS After the Mann-Whitney U test the vibrational modes of CO (Collagen 1), PO2 (Nucleic Acids) and CO asymmetric (Triglycerides/Lipids) were observed as a possible spectral biomarker. These bands were chosen because they represent the vibrational modes related to collagen and DNA, which are supposed to be changed in AC samples. Based on the PCA-LDA results, the predictive model corresponding to the area under the curve was 0.91 for the fingerprint region and 0.83 for the high wavenumber region, showing the greater accuracy of the test. CONCLUSIONS FT-IR changes in collagen and nucleic acids could be used as molecular biomarkers for malignant transformation.
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Affiliation(s)
| | - Thiago Martini Pereira
- Instituto de Ciência e Tecnologia, Universidade Federal de São Paulo, São José dos campos, São Paulo, Brazil
| | - Taciana Depra Magrini
- Laboratory of Biomedical Vibrational Spectroscopy, Universidade do Vale do Paraíba, São José dos Campos, São Paulo, Brazil
| | - Ana Sueli Rodrigues Cavalcante
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, Univ Estadual Paulista (UNESP), São José dos Campos, São Paulo, Brazil
| | | | - Janete Dias Almeida
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, Univ Estadual Paulista (UNESP), São José dos Campos, São Paulo, Brazil
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In vivo confocal microscopy for the oral cavity: Current state of the field and future potential. Oral Oncol 2016; 54:28-35. [PMID: 26786962 DOI: 10.1016/j.oraloncology.2016.01.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 12/24/2015] [Accepted: 01/04/2016] [Indexed: 12/13/2022]
Abstract
Confocal microscopy (CM) has been shown to correlate with oral mucosal histopathology in vivo. The purposes of this review are to summarize what we know so far about in vivo CM applications for oral mucosal pathologies, to highlight some current developments with CM devices relevant for oral applications, and to formulate where in vivo CM could hold further application for oral mucosal diagnosis and management. Ovid Medline® and/or Google® searches were performed using the terms 'microscopy, confocal', 'mouth neoplasms', 'mouth mucosa', 'leukoplakia, oral', 'oral lichen planus', 'gingiva', 'cheilitis', 'taste', 'inflammatory oral confocal', 'mucosal confocal' and 'confocal squamous cell oral'. In summary, inclusion criteria were in vivo use of any type of CM for the human oral mucosa and studies on normal or pathological oral mucosa. Experimental studies attempting to identify proteins of interest and microorganisms were excluded. In total 25 relevant articles were found, covering 8 main topics, including normal oral mucosal features (n=15), oral dysplasia or neoplasia (n=7), inflamed oral mucosa (n=3), taste impairment (n=3), oral autoimmune conditions (n=2), pigmented oral pathology/melanoma (n=1), delayed type hypersensitivity (n=1), and cheilitis glandularis (n=1). The evidence for using in vivo CM in these conditions is poor, as it is limited to mainly small descriptive studies. Current device developments for oral CM include improved probe design. The authors propose that future applications for in vivo oral CM may include burning mouth syndrome, intra-operative mapping for cancer surgery, and monitoring and targeted biopsies within field cancerization.
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Maier T, Cekovic D, Ruzicka T, Sattler E, Berking C. Treatment monitoring of topical ingenol mebutate in actinic keratoses with the combination of optical coherence tomography and reflectance confocal microscopy: a case series. Br J Dermatol 2015; 172:816-8. [DOI: 10.1111/bjd.13304] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- T. Maier
- Department of Dermatology and Allergology; University Hospital of Munich; Frauenlobstraße 9-11 D-80337 Munich Germany
| | - D. Cekovic
- Department of Dermatology and Allergology; University Hospital of Munich; Frauenlobstraße 9-11 D-80337 Munich Germany
| | - T. Ruzicka
- Department of Dermatology and Allergology; University Hospital of Munich; Frauenlobstraße 9-11 D-80337 Munich Germany
| | - E.C. Sattler
- Department of Dermatology and Allergology; University Hospital of Munich; Frauenlobstraße 9-11 D-80337 Munich Germany
| | - C. Berking
- Department of Dermatology and Allergology; University Hospital of Munich; Frauenlobstraße 9-11 D-80337 Munich Germany
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Malvehy J. A new vision of actinic keratosis beyond visible clinical lesions. J Eur Acad Dermatol Venereol 2014; 29 Suppl 1:3-8. [DOI: 10.1111/jdv.12833] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 10/06/2014] [Indexed: 12/01/2022]
Affiliation(s)
- J. Malvehy
- Melanoma Skin Unit; University Hospital Clinic of Barcelona; Barcelona Spain
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Spyridonos P, Gaitanis G, Tzaphlidou M, Bassukas ID. Spatial fuzzy c-means algorithm with adaptive fuzzy exponent selection for robust vermilion border detection in healthy and diseased lower lips. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2014; 114:291-301. [PMID: 24661607 DOI: 10.1016/j.cmpb.2014.02.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 02/17/2014] [Accepted: 02/26/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Accurate lip contour identification is demanding since variations in color, form and surface texture, even in normal lips, introduce artifacts in non-adapted segmentation algorithms. Herein, a method for vermilion border detection and quantification in healthy and diseased lower lips is presented. AIM To quantify the morphological irregularities of lower lip border, to validate its discriminative power in solar cheilosis diagnosis and to provide supportive tools toward, cost effective, non invasive, disease monitoring. MATERIALS Segmentation algorithm for lower lip border was based on spatial fuzzy c-means clustering algorithm with adaptive selection of fuzzy exponent m. Lip features measuring morphological lip border deviations were estimated. The method of lip border extraction and quantitative description was evaluated in a gold standard set of 25 young volunteers without onset of lip diseases. Quantitative descriptors were evaluated in terms of correct classification rates in differentiating 30 healthy control cases from 41 patients with solar cheilosis and were further applied to quantify the therapeutic outcome after immunocryosurgery in eight patients with solar cheilosis. RESULTS Adaptive estimation of fuzzy exponent m substantially boosted the segmentation quality in gold standard cases yielding quite smooth lip contours and uniformly low values of lip irregularity features. Discriminant analysis highlighted the distance between the extracted and modeled vermilion border as a feature with excellent diagnostic accuracy (sensitivity and specificity 98% and 93% respectively). Results on patients with solar cheilosis followed up after treatment with immunocryosurgery showed that proposed quantitative lip marker was able to trace the improvement of disease after treatment. CONCLUSION Correct lip border recognition is the prerequisite for extracting essential morphological descriptors from lips with epithelial diseases like solar cheilosis. In this paper we presented an efficient method for the automatic identification and quantitative description of lower lip vermilion border morphology in health and disease using digital photography and image analysis techniques.
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Affiliation(s)
- Panagiota Spyridonos
- Department of Medical Physics, University of Ioannina, School of Health Sciences, University Campus, 45110 Ioannina, Greece.
| | - Georgios Gaitanis
- Department of Skin and Venereal Diseases, University of Ioannina, School of Health Sciences, University Campus, 45110 Ioannina, Greece
| | - Margaret Tzaphlidou
- Department of Medical Physics, University of Ioannina, School of Health Sciences, University Campus, 45110 Ioannina, Greece.
| | - Ioannis D Bassukas
- Department of Skin and Venereal Diseases, University of Ioannina, School of Health Sciences, University Campus, 45110 Ioannina, Greece
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Sattler ECE, Poloczek K, Kästle R, Welzel J. Confocal laser scanning microscopy and optical coherence tomography for the evaluation of the kinetics and quantification of wound healing after fractional laser therapy. J Am Acad Dermatol 2013; 69:e165-73. [DOI: 10.1016/j.jaad.2013.04.052] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 04/19/2013] [Accepted: 04/26/2013] [Indexed: 11/24/2022]
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[Precancerous tumors and carcinomas in situ of the skin]. Internist (Berl) 2013; 54:671-82. [PMID: 23657620 DOI: 10.1007/s00108-012-3216-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Precancerous skin lesions and carcinomas in situ of the skin represent the early stages of epithelial skin tumors. There is no invasive tumor growth, so the basement membrane is completely intact. These lesions show a wide variation of clinical and histological appearances on the skin or mucosa. The precancerous and carcinoma in situ lesions that are described in this text are actinic keratosis, actinic cheilitis, cutaneous horns, arsenical keratosis, tar-induced dermatosis, X-ray irradiation-related keratosis, Bowen's disease, erythroplasia of Queyrat, bowenoid papulosis, intraepithelial neoplasia (vulvar, penile and anal). Because they all can progress into invasive carcinoma, therapy is mandatory. Many noninvasive therapeutic approaches exist nowadays in the form of gels, creams, photodynamic therapy and invasive techniques such as laser therapy and cryotherapy, curettage and excision of lesional skin. Depending on the treatment process, different rates of general clearance and recurrence of the lesions are discussed in this article.
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Sattler EC, Maier T, Hoffmann VS, Hegyi J, Ruzicka T, Berking C. Noninvasive in vivo detection and quantification of Demodex mites by confocal laser scanning microscopy. Br J Dermatol 2013; 167:1042-7. [PMID: 22716072 DOI: 10.1111/j.1365-2133.2012.11096.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In many Demodex-associated skin diseases Demodex mites are present in abundance and seem to be at least partially pathogenic. So far all diagnostic approaches such as scraping or standardized superficial skin biopsy are (semi-)invasive and may cause discomfort to the patient. OBJECTIVES To see whether confocal laser scanning microscopy (CLSM) - a noninvasive method for the visualization of superficial skin layers - is able to detect and quantify D. folliculorum in facial skin of patients with rosacea. METHODS Twenty-five patients (34-72 years of age) with facial rosacea and 25 age- and sex-matched normal controls were examined by CLSM. Mosaics of 8 × 8 mm and 5 × 5 mm were created by scanning horizontal layers of lesional skin and quantification of mites per follicle and per area as well as follicles per area was performed. RESULTS In all patients D. folliculorum could be detected by CLSM and presented as roundish or lengthy cone-shaped structures. CLSM allowed the quantification of Demodex mites and revealed significant differences (P < 0·0001): the mean number of mites was 165·4 per 8 × 8 mm area and 94·2 per 5 × 5 mm area in the patients compared with 34·7 and 22·4, respectively, in the controls. The corresponding mean number of mites per follicle was 0·7 and 0·8, respectively, in the patients and 0·1 and 0·2, respectively, in the controls. CONCLUSIONS With the help of CLSM it is possible to detect, image and quantify Demodex mites noninvasively in facial skin of patients with rosacea.
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Affiliation(s)
- E C Sattler
- Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Frauenlobstr. 9-11, 80337 Munich, Germany.
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Boone MALM, Norrenberg S, Jemec GBE, Del Marmol V. Imaging actinic keratosis by high-definition optical coherence tomography. Histomorphologic correlation: a pilot study. Exp Dermatol 2013; 22:93-7. [DOI: 10.1111/exd.12074] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Marc A. L. M. Boone
- Dermatology Department; Hôpital Erasme; Université Libre de Bruxelles; Brussels; Belgium
| | - Sarah Norrenberg
- Dermatology Department; Hôpital Erasme; Université Libre de Bruxelles; Brussels; Belgium
| | - Gregor B. E. Jemec
- Dermatology Department; Roskilde Hospital; University of Copenhagen; Copenhagen; Denmark
| | - Veronique Del Marmol
- Dermatology Department; Hôpital Erasme; Université Libre de Bruxelles; Brussels; Belgium
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In vivo reflectance confocal microscopy for early diagnosis of nonmelanoma skin cancer. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:784-9. [DOI: 10.1016/j.ad.2011.10.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 10/23/2011] [Accepted: 10/29/2011] [Indexed: 11/24/2022] Open
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In vivo reflectance confocal microscopy for early diagnosis of nonmelanoma skin cancer. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2011.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Wolberink E, van Erp P, de Boer-van Huizen R, van de Kerkhof P, Gerritsen M. Reflectance confocal microscopy: an effective tool for monitoring ultraviolet B phototherapy in psoriasis. Br J Dermatol 2012; 167:396-403. [DOI: 10.1111/j.1365-2133.2012.10988.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ulrich M, Lange-Asschenfeldt S, Gonzalez S. The use of reflectance confocal microscopy for monitoring response to therapy of skin malignancies. Dermatol Pract Concept 2012; 2:202a10. [PMID: 23785598 PMCID: PMC3663336 DOI: 10.5826/dpc.0202a10] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Accepted: 02/25/2012] [Indexed: 01/12/2023] Open
Abstract
SUMMARY Reflectance confocal microscopy (RCM) is a new non-invasive imaging technique that enables visualizing cells and structures in living skin in real-time with resolution close to that of histological analysis. RCM has been successfully implemented in the assessment of benign and malignant lesions. Most importantly, it also enables monitoring dynamic changes in the skin over time and in response to different therapies, e.g., imiquimod, photodynamic therapy, and others. Given the often traumatic nature of skin cancer that affects both the physiology and the psychology of the patients, it is crucial to have methods that enable monitoring the response to treatment but that minimize the distress and discomfort associated with such process. This article provides a very brief overview of the fundamentals of RCM and then focuses on its recent employment as a monitoring tool in skin cancer and other pathologies that may require frequent follow-up.
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Affiliation(s)
- Martina Ulrich
- Department of Dermatology, Skin Cancer Center, Charité Universitätsmedizin, Berlin, Germany
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Liu H, Lin Y, Chen X, Wang N, Shan X, Tian H, Zhou G, Zhang F. Evaluation of colloid milium by in vivo reflectance confocal microscopy. J Eur Acad Dermatol Venereol 2012; 27:262-3. [PMID: 22385339 DOI: 10.1111/j.1468-3083.2012.04460.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sattler E, Kästle R, Arens-Corell M, Welzel J. How long does protection last? - In vivo fluorescence confocal laser scanning imaging for the evaluation of the kinetics of a topically applied lotion in an everyday setting. Skin Res Technol 2011; 18:370-7. [DOI: 10.1111/j.1600-0846.2011.00579.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2011] [Indexed: 11/29/2022]
Affiliation(s)
- E. Sattler
- Department of Dermatology and Allergology; Ludwig-Maximilians-University of Munich; Munich; Germany
| | - R. Kästle
- Department of Dermatology and Allergology; General Hospital Augsburg; Augsburg; Germany
| | | | - J. Welzel
- Department of Dermatology and Allergology; General Hospital Augsburg; Augsburg; Germany
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