ABSTRACT
BACKGROUND: Reflectance confocal microscopy (RCM) has been recently shown to be effective for measuring the Demodex mite density. OBJECTIVES: To compare and demonstrate the advantages and disadvantages of standardized skin surface biopsy (SSSB) and RCM for measuring the density of Demodex mites. MATERIALS AND METHODS: Forty-eight patients (30 female, 18 male) and 47 healthy controls (30 female, 17 male) were enrolled in the study. The patients diagnoses were pityriasis folliculorum (n = 40), papulopustulary rosecea (n = 7) and erythema-telengiectatic rosacea (n = 1). The area with the most intense erythema on the right cheek was selected for imaging with RCM (VivaScope 3000) and SSSB. RESULTS: Forty-two patients demonstrated high Demodex density [(Dd) > 5 mites/cm(2) ] with SSSB (85.7%). RCM identified demodicosis in 48 patients (100%). The mean Dd measured with RCM (409.8 ± 209.2) was significantly higher than SSSB (15.33 ± 18.1) (P < 0.001). In the patients, RCM demonstrated the mean number of mites 40.90 ± 20.9 and 4.11 ± 6.4 in the controls per 10 mm(2) area. The corresponding mean number of 2.63 ± 0.77 mites was detected in the infested follicles per area of view compared to a mean of 0.77 ± 0.98 mites in the infested follicles in the controls (P < 0.001). CONCLUSION: Reflectance confocal microscopy is a fast, direct and noninvasive method for Demodex-associated diseases and it is superior to SSSB for Demodex mite detection.
Subject(s)
Microscopy, Confocal/methods , Microscopy, Interference/methods , Mite Infestations/pathology , Mite Infestations/parasitology , Mites/cytology , Skin/pathology , Skin/parasitology , Adult , Animals , Biopsy/methods , Dermoscopy/methods , Female , Humans , Male , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
BACKGROUND/PURPOSE: Increased interest in antiaging methods, mandates a development of reliable noninvasive technique to assess skin aging. In this study, we aimed to determine the effects of photoaging at histopathologic resolution by means of reflectance confocal microscopy. METHOD: The sun-exposed malar area, the anterior aspect of ear lobule, and the sun-protected posterior aspect of ear lobule had been evaluated in 120 volunteers from different age groups over 10 previously reported and new confocal parameters for skin aging. RESULT: The sun-exposed areas revealed more frequent irregular honeycomb pattern, polycylic papillary contours, coarse collagen, huddled collagen, curled bright structures with higher epidermal thickness, and furrow depth values. However, the incidence of thin reticulated collagen and the number of dermal papillae were statistically higher on the sun-protected posterior aspect of ear lobule. CONCLUSION: Reflectance confocal microscopy is a reliable diagnostic technique for evaluation of skin photoaging with objective criteria. With the new emerging compact models it is possible to scan even the least accessible body parts with no discomfort to the patient, which offers the possibility to assess the effect of antiaging applications and to identify early signs of solar damage in cosmetically sensitive areas.
