Combined Application of Dual-Wavelength Fluorescence Monitoring and Contactless Thermometry during Photodynamic Therapy of Basal Cell Skin Cancer.

The aim of the study was to assess the capabilities of combined application of dual-wavelength fluorescence visualization and contactless skin thermometry during photodynamic therapy monitoring (PDT) of basal cell cancer. MATERIALS AND METHODS: The study was performed at the University Clinic of Privolzhsky Research Medical University (Nizhny Novgorod). Nine clinically, dermatoscopically, and histologically verified foci of basal cell skin cancer were exposed to PDT sessions (wavelength of 662 nm, light dose density of 150 J/cm2) with systemic application of chlorin-based photosensitizer Fotoditazin. A semiconductor laser system Latus-T (Russia) was employed for irradiation. Dual-wavelength fluorescence visualization and contactless thermometry with an IR pyrometer were used to monitor the PDT sessions. RESULTS: The PDT sessions of nine foci of basal cell cancer were carried out under the control of fluorescence imaging and contactless thermometry. Photosensitizer photobleaching in all foci amounted to 40% signifying a percent of photosensitizer involved in the photodynamic reaction. It has been shown that the combined employment of dual-wavelength fluorescence monitoring and contactless thermometry during the PDT of basal cell skin cancer allows oncologists to control simultaneously the degree of photosensitizer photobleaching and the depth of the photodynamic effect in tissues, the extent of involving the mechanisms associated with hyperthermia as well as the correctness of the procedure conducting. In the course of 9-month dynamic follow-up after the treatment, no clinical and dermatoscopic signs of recurrence were found. CONCLUSION: A bimodal control of PDT enables the assessment of the correctness and efficacy of the procedure performance. The contactless control of tissue heating allows ensuring the temperature mode for hyperthermia realization, while the fluorescence monitoring makes it possible to evaluate the accumulation of the photosensitizer in the tumor and the depth of the PDT action as well as to predict the procedure efficacy based on the photobleaching data. The complementary use of these techniques allows the adjustment of the mode directly in the course of the PDT procedure. The acquisition of the sufficient statistical data on the combined monitoring will result in the development of a novel PDT protocol.

Identification of layers in optical coherence tomography of skin: comparative analysis of experimental and Monte Carlo simulated images.

BACKGROUND/PURPOSE: The goal of the study is comparative analysis of the layers in OCT images and the morphological structure of skin with thick and thin epidermis. METHODS: We analyzed the difference between skin with thin and thick epidermis in two ways. The first approach consisted in determination of the thicknesses of layers of skin with thin and thick epidermis of different localizations from experimental OCT images. The second approach was to develop numerical models fitting experimental OCT images based on Monte Carlo simulations revealing structure and optical parameters of layers of skin with thick and thin epidermis. RESULTS: The correspondence between the OCT images of skin with thin and thick epidermis and the morphological structure was confirmed. OCT images of healthy skin comprise three layers in case of skin with thin epidermis and four layers in skin with thick epidermis. The OCT image of the zone of the transition from skin with thick to skin with thin epidermis features five layers. CONCLUSION: The revealed differences in the structure of horny and cellular layers of epidermis, as well as of papillary and reticular dermis in skin with thin and thick epidermis specify different optical properties of these layers in OCT images.

Morphological changes in skin of different phototypes under the action of topical corticosteroid therapy and tacrolimus.

BACKGROUND/PURPOSE: The present study aimed to investigate the influence of topical corticosteroid therapy and tacrolimus on morphological indices of different skin phototypes and to optimize topical therapy using the OCT technique. METHODS: Twenty healthy volunteers aging from 20 to 30 (14 men and 6 women) took part in the study: 10 persons with skin phototype I, II and 10 persons with skin phototype V, VI. Morphological state of the skin was assessed before and during application of topical steroids of different strength and calciumneurin inhibitors for 49 days. Morphological state was studied in vivo using the optical coherence tomograph. RESULTS: Morphological manifestations of skin atrophy with the use of clobetasol propionate appear earlier than with the use of hydrocortisone 17-butyrate; this process was faster in representatives of groups V, VI. Epidermal thinning in the zone of tacrolimus application was not recorded in any phototype. CONCLUSION: Recording of early preclinical signs of epidermis thinning in the course of OCT follow-up may be an indication for changing the corticosteroid therapy by calciumneurin inhibitors, which will permit to individualize the therapy, to increase its efficacy, and to minimize the possibility of complications in each particular case.

Complex assessment of age-specific morphofunctional features of skin of different anatomic localizations.

OBJECTIVE: The goal of the described study was complex assessment of age-specific morphofunctional features of skin of different anatomic localization using optical coherence tomography (OCT). METHODS: Forty-three healthy volunteers aging from 4 to 74 years were enrolled in the study. Optical and functional skin parameters were studied in 18 areas of the human body. All the studied areas were classified as open and closed, depending on external impact. Structural parameters of skin were determined by means of the OCT device equipped with a removable, flexible probe with microscanner (registration certificate no. 022a2035/2213-05) designed and fabricated at the IAP RAS (Nizhny Novgorod, Russia) with longitudinal and transverse resolution of about 20 µm. RESULTS: Age-specific morphofunctional features of skin most evident in areas exposed to external action were found. Statistically significant difference in elasticity (-0.57, P = 0.00012) in areas closed to external action (further referred to as closed areas) and in useful signal depth, hydration and elasticity in areas exposed to external action (further referred to as open areas) was assessed for different age groups. Analysis of the dependence of parameters on age showed statistically significant correlations between age and thickness of cellular layers of the epidermis (-0.33, P = 0.035), pigmentation level (-0.22, P = 0.044) and elasticity in closed areas and highly significant correlations between age and hydration and elasticity in open areas. CONCLUSION: The current work is concerned with investigation of age-specific morpho-functional parameters of skin of different localizations.