Comprehensive vascular imaging using optical coherence tomography-based angiography and photoacoustic tomography.

Studies have proven the relationship between cutaneous vasculature abnormalities and dermatological disorders, but to image vasculature noninvasively

In vivo dual-modality photoacoustic and optical coherence tomography imaging of human dermatological pathologies.

Vascular abnormalities serve as a key indicator for many skin diseases. Currently available methods in dermatology such as histopathology and dermatoscopy analyze underlying vasculature in human skin but are either invasive, time-consuming, and laborious or incapable of providing 3D images. In this work, we applied for the first time dual-modality photoacoustic and optical coherence tomography that provides complementary information about tissue morphology and vasculature of patients with different types of dermatitis. Its noninvasiveness and relatively short imaging time and the wide range of diseases that it can detect prove the merits of the dual-modality imaging system and show the great potential of its clinical use in the future.

A prospective study of mobile phones for dermatology in a clinical setting.

We evaluated the accuracy of diagnoses made from pictures taken with the built-in cameras of mobile phones in a 'real-life' clinical setting. A total of 263 patients took part, who photographed their own lesions where possible, and provided clinical information via a questionnaire. After the teledermatology procedure, each patient was examined face-to-face and a gold standard diagnosis was made. The telemedicine data and pictures were diagnosed by 15 dermatologists. The 299 cases contained 1-22 clinical images each (median 3). Nine dermatologists finished all the cases and the remaining six completed some of them, thus providing 2893 decisions. Overall, 61% of all cases were rated as possible to diagnose and of those, 80% were correct in comparison with the face-to-face diagnosis. Image quality was evaluated and the median was 5 on a 10-point scale. There was a significant correlation between the correct diagnosis and the quality of the photographs taken (P < 0.001). In nearly two-thirds of all cases, a teledermatology diagnosis was possible; however, there was insufficient information to make a telemedicine diagnosis in about one-third of the cases. If applied carefully, mobile phones could be a powerful tool for people to optimize their health care status.

Three-dimensional multiphoton/optical coherence tomography for diagnostic applications in dermatology.

A preliminary clinical trial using state-of-the-art multiphoton tomography (MPT) and optical coherence tomography (OCT) for three-dimensional (3D) multimodal in vivo imaging of normal skin, nevi, scars and pathologic skin lesions has been conducted. MPT enabled visualization of sub-cellular details with axial and transverse resolutions of <2 µm and <0.5 µm, respectively, from a volume of 0.35 × 0.35 × 0.2 mm(3) at a frame rate of 0.14 Hz (512 × 512 pixels). State-of-the-art OCT, operating at a center wavelength of 1300 nm, was capable of acquiring 3D images depicting the layered architecture of skin with axial and transverse resolutions ~8 µm and ~20 µm, respectively, from a volume of 7 × 3.5 × 1.5 mm(3) at a frame rate of 46 Hz (1024 × 1024 pixels). This study demonstrates the clinical diagnostic potential of MPT/OCT for pre-screening relatively large areas of skin using 3D OCT to identify suspicious regions at microscopic level and subsequently using high resolution MPT to obtain zoomed in, sub-cellular level information of the respective regions.

In situ structural and microangiographic assessment of human skin lesions with high-speed OCT.

We demonstrate noninvasive structural and microvascular contrast imaging of different human skin diseases in vivo using an intensity difference analysis of OCT tomograms. The high-speed swept source OCT system operates at 1310 nm with 220 kHz A-scan rate. It provides an extended focus by employing a Bessel beam. The studied lesions were two cases of dermatitis and two cases of basal cell carcinoma. The lesions show characteristic vascular patterns that are significantly different from healthy skin. In case of inflammation, vessels are dilated and perfusion is increased. In case of basal cell carcinoma, the angiogram shows a denser network of unorganized vessels with large vessels close to the skin surface. Those results indicate that assessing vascular changes yields complementary information with important insight into the metabolic demand.

Melanoma arising in a giant nevus spilus maculosus.

Melanoma arising in a nevus spilus is rare. There are two distinct types of nevus spilus characterized by macular or papular speckles, respectively. We report the case of a melanoma that arose in association with a giant nevus spilus maculosus.

Leishmaniasis in the tongue of an immunocompetent man.

A 49-year-old immunocompetent white man had a painful ulcer (1.5 cm in diameter) on the left ventrolateral surface of a grossly enlarged tongue. The ulcer was present for two months. Impaired swallowing resulted in substantial weight loss and fatigue. Histopathologic analysis of a punch biopsy specimen indicated numerous Leishman Donovan bodies within macrophages. A polymerase chain reaction confirmed the presence of L. donovani. Therapy with two cycles of liposomal amphotericin B over a three-month period was administered. Four months after discharge, the ulcer had healed completely and the tongue returned to its normal size and function.