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Khan S, Farabi B, Zufall A, Truong T, Safai B, Rao B, Mir A. Rapid diagnosis and clinical management of kerion in a pediatric patient with reflectance confocal microscopy. JAAD Case Rep 2023; 38:48-50. [PMID: 37456511 PMCID: PMC10338897 DOI: 10.1016/j.jdcr.2023.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Affiliation(s)
- Samavia Khan
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey
| | - Banu Farabi
- Dermatology Department, New York Medical College, Valhalla, New York
- Dermatology Department, NYC Health + Hospital/Metropolitan, New York, New York
- Dermatology Department, NYC Health + Hospital/Coney Island, Brooklyn, New York
| | - Alina Zufall
- Dermatology Department, New York Medical College, Valhalla, New York
- Dermatology Department, NYC Health + Hospital/Metropolitan, New York, New York
- Dermatology Department, NYC Health + Hospital/Coney Island, Brooklyn, New York
| | - Thu Truong
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey
| | - Bijan Safai
- Dermatology Department, New York Medical College, Valhalla, New York
- Dermatology Department, NYC Health + Hospital/Metropolitan, New York, New York
- Dermatology Department, NYC Health + Hospital/Coney Island, Brooklyn, New York
| | - Babar Rao
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, New Jersey
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Adnan Mir
- Dermatology Department, New York Medical College, Valhalla, New York
- Dermatology Department, NYC Health + Hospital/Metropolitan, New York, New York
- Dermpath Diagnostics, White Plains, New York
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Vingan NR, Parsa S, Barillas J, Culver A, Kenkel JM. Evaluation and characterization of facial skin aging using optical coherence tomography. Lasers Surg Med 2023; 55:22-34. [PMID: 36208115 DOI: 10.1002/lsm.23611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/05/2022] [Accepted: 09/26/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The skin aging exposome encompasses internal and external factors that contribute to clinical signs of facial aging. Aging skin can be characterized by distinctive features such as wrinkles, lentigines, elastosis, and roughness. Optical coherence tomography (OCT) is capable of noninvasively measuring skin characteristics. This study aimed to assess bilateral features using OCT to explore temporal skin changes among decades and potential changes in facial skin aging based on laterality. METHODS A total of 97 subjects between 20 and 89 years old with Fitzpatrick skin types I to IV were enrolled. VivoSight, a Multi-Beam OCT system intended to gather topographical and histological images of skin, was used to scan the area inferolateral to the lateral canthus, bilaterally. Investigators compared characteristics of skin roughness, attenuation coefficient and blood flow across age groups and based on laterality to determine any differences. RESULTS Only data from successful OCT scans were used. Seventy subjects, 10 from each specified decade, had successful bilateral scans and were thus included in the analysis. Chronological aging was characterized by significantly decreased dermal attenuation coefficient with increased age. Skin roughness measurements showed trends of increased roughness with age; however, no statistically significant changes were seen between groups. Qualitative differences amongst scans taken on right and left sides of the face showed no significance regarding roughness, density or blood flow at depths ranging from 0.05 to 0.5 mm. CONCLUSIONS OCT is an effective method for evaluating changes in aging skin. Our results illustrate a decline in skin density with chronological age. Additionally, it was illustrated that structural change in the epidermis and dermis does occur, however on a microscopic scale, there are no significant differences based on laterality. OCT holds promise as a noninvasive technique for characterization of aging skin. Its utility and application in the clinical management and treatment of aged skin requires further research; however, the technology has potential to personalize therapies based on objective findings.
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Affiliation(s)
- Nicole R Vingan
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Shyon Parsa
- University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - Jennifer Barillas
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Abby Culver
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jeffrey M Kenkel
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
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Abstract
In vivo reflectance confocal microscopy (RCM) is a noninvasive high-resolution skin imaging tool that has become an important adjunct to clinical exam, dermoscopy and histopathology assessment, in the diagnosis and management of melanoma. RCM generates a horizontal view of the skin, whereby cellular and subcellular (e.g., nuclei, melanophages, collagen) structures, to the level of the upper dermis, are projected onto a screen at near-histological resolution. Morphologic descriptors, standardized terminology, and diagnostic algorithms are well established for the RCM assessment of melanoma, melanocytic, and nonmelanocytic lesions. Clinical applications of RCM in melanoma are broad and include diagnosis, assessment of large lesions on cosmetically sensitive areas, directing areas to biopsy, delineating margins prior to surgery, detecting response to treatment and assessing recurrence. This review will provide an overview of RCM technology, findings by melanoma subtype, clinical applications, as well as explore the accuracy of RCM for melanoma diagnosis, pitfalls and emerging uses of this technology ex vivo.
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Affiliation(s)
- Andréanne Waddell
- Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Department of Medicine/Division of Dermatology, Université de Sherbrooke, Sherbrooke, Quebec, Canada.,Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Department of Medicine/Division of Dermatology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Phoebe Star
- Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia.,Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia
| | - Pascale Guitera
- Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia.,Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.,Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia.,Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
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