Application of optical coherence tomography in non-invasive characterization of skin vascular lesions.

BACKGROUND: Optical coherence tomography (OCT) is a new non-invasive approach for real-time in vivo tissue characterization. A promising use of OCT can be the assessment of the architecture of lesions with some degree of inhomogeneities, such as vascular lesions. Knowledge of the size and depth of the vascular structures can be useful for the diagnosis and for choosing the best treatment. OBJECTIVE: The purpose of this study was to investigate a series of vascular lesions by means of OCT in order to obtain new insights into the non-invasive, pre-operative analysis of these lesions. METHODS: Seven vascular lesions were included in the study. Histopathological diagnosis showed two haemangiomas and one haemolymphangioma; the remaining four cases were classified as haemangiomas on the basis of their clinical appearance. RESULTS: In all lesions, OCT analysis was able to visualize different areas of the lesion from the horny layer to the dermis showing a clear image of the vascular proliferation. Specifically, oval to roundish signal-poor areas sharply demarcated by a surrounding signal-rich layer were observed in good correlation with histopathology. CONCLUSION: The analysis of vascular lesions by OCT provides a new insight into non-invasive diagnosis and can be helpful in the selection of the most appropriate treatment.

The CD40/CD40 ligand system is involved in the pathogenesis of pemphigus.

The CD40/CD40 ligand (CD40L) system has never been investigated in autoimmune bullous diseases belonging to the pemphigus group in humans. Skin biopsy specimens from 21 patients with pemphigus vulgaris, 10 with pemphigus foliaceous and healthy volunteers were studied by immunohistochemistry (for CD40 and CD40L) and reversal transcriptase polymerase-chain reaction (for CD40L), while sera were analyzed by enzyme-linked immunosorbent assay for soluble CD40L. In all pemphigus specimens, the basal and suprabasal layers of the epidermis and perivascular infiltrating cells were CD40+. CD40L+ cells moderately infiltrated the perivascular and interstitial dermis of pemphigus specimens. CD40L mRNA was strongly evident in all pemphigus samples while no signal was detected in the healthy controls. The expression of soluble CD40L was significantly greater in pemphigus sera than in controls. We showed here that the CD40/CD40L system is upregulated both in lesional skin and in serum of patients with pemphigus.