Noninvasive diagnosis in dermatology
Summary In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy allows for high‐resolution imaging of the epidermis and upper dermis. It is particularly suitable in the differential diagnosis of melanocytic l...
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| Vydáno v: | Journal der Deutschen Dermatologischen Gesellschaft Ročník 15; číslo 10; s. 999 - 1016 |
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01.10.2017
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| Abstract | Summary
In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy allows for high‐resolution imaging of the epidermis and upper dermis. It is particularly suitable in the differential diagnosis of melanocytic lesions. Optical coherence tomography (OCT) has a lower resolution compared to confocal laser microscopy but a greater depth of penetration. It is primarily used for imaging epithelial skin cancer, especially in the context of monitoring the effectiveness of nonsurgical therapies. Electrical impedance spectroscopy does not yield cutaneous images but rather provides a score based on the cellular irregularity of the skin. Multispectral analysis involves illumination of the skin with different wavelengths and likewise results in the computation of a score. Both methods are used in the differentiation of dysplastic nevi from melanoma. Other diagnostic imaging and biophysical methods are currently still in the developmental stages.By increasing the sensitivity and specificity of clinical and dermoscopic findings, the aforementioned methods bring about an improvement in noninvasive diagnosis. They allow for skin lesions to be monitored over time and therapeutic effects to be quantified. Finally, they facilitate early diagnosis of skin cancer, and help avoid unnecessary surgery of benign lesions. |
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| AbstractList | In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy allows for high-resolution imaging of the epidermis and upper dermis. It is particularly suitable in the differential diagnosis of melanocytic lesions. Optical coherence tomography (OCT) has a lower resolution compared to confocal laser microscopy but a greater depth of penetration. It is primarily used for imaging epithelial skin cancer, especially in the context of monitoring the effectiveness of nonsurgical therapies. Electrical impedance spectroscopy does not yield cutaneous images but rather provides a score based on the cellular irregularity of the skin. Multispectral analysis involves illumination of the skin with different wavelengths and likewise results in the computation of a score. Both methods are used in the differentiation of dysplastic nevi from melanoma. Other diagnostic imaging and biophysical methods are currently still in the developmental stages. By increasing the sensitivity and specificity of clinical and dermoscopic findings, the aforementioned methods bring about an improvement in noninvasive diagnosis. They allow for skin lesions to be monitored over time and therapeutic effects to be quantified. Finally, they facilitate early diagnosis of skin cancer, and help avoid unnecessary surgery of benign lesions. Summary In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy allows for high-resolution imaging of the epidermis and upper dermis. It is particularly suitable in the differential diagnosis of melanocytic lesions. Optical coherence tomography (OCT) has a lower resolution compared to confocal laser microscopy but a greater depth of penetration. It is primarily used for imaging epithelial skin cancer, especially in the context of monitoring the effectiveness of nonsurgical therapies. Electrical impedance spectroscopy does not yield cutaneous images but rather provides a score based on the cellular irregularity of the skin. Multispectral analysis involves illumination of the skin with different wavelengths and likewise results in the computation of a score. Both methods are used in the differentiation of dysplastic nevi from melanoma. Other diagnostic imaging and biophysical methods are currently still in the developmental stages. By increasing the sensitivity and specificity of clinical and dermoscopic findings, the aforementioned methods bring about an improvement in noninvasive diagnosis. They allow for skin lesions to be monitored over time and therapeutic effects to be quantified. Finally, they facilitate early diagnosis of skin cancer, and help avoid unnecessary surgery of benign lesions. In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy allows for high-resolution imaging of the epidermis and upper dermis. It is particularly suitable in the differential diagnosis of melanocytic lesions. Optical coherence tomography (OCT) has a lower resolution compared to confocal laser microscopy but a greater depth of penetration. It is primarily used for imaging epithelial skin cancer, especially in the context of monitoring the effectiveness of nonsurgical therapies. Electrical impedance spectroscopy does not yield cutaneous images but rather provides a score based on the cellular irregularity of the skin. Multispectral analysis involves illumination of the skin with different wavelengths and likewise results in the computation of a score. Both methods are used in the differentiation of dysplastic nevi from melanoma. Other diagnostic imaging and biophysical methods are currently still in the developmental stages. By increasing the sensitivity and specificity of clinical and dermoscopic findings, the aforementioned methods bring about an improvement in noninvasive diagnosis. They allow for skin lesions to be monitored over time and therapeutic effects to be quantified. Finally, they facilitate early diagnosis of skin cancer, and help avoid unnecessary surgery of benign lesions.In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy allows for high-resolution imaging of the epidermis and upper dermis. It is particularly suitable in the differential diagnosis of melanocytic lesions. Optical coherence tomography (OCT) has a lower resolution compared to confocal laser microscopy but a greater depth of penetration. It is primarily used for imaging epithelial skin cancer, especially in the context of monitoring the effectiveness of nonsurgical therapies. Electrical impedance spectroscopy does not yield cutaneous images but rather provides a score based on the cellular irregularity of the skin. Multispectral analysis involves illumination of the skin with different wavelengths and likewise results in the computation of a score. Both methods are used in the differentiation of dysplastic nevi from melanoma. Other diagnostic imaging and biophysical methods are currently still in the developmental stages. By increasing the sensitivity and specificity of clinical and dermoscopic findings, the aforementioned methods bring about an improvement in noninvasive diagnosis. They allow for skin lesions to be monitored over time and therapeutic effects to be quantified. Finally, they facilitate early diagnosis of skin cancer, and help avoid unnecessary surgery of benign lesions. Summary In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy allows for high‐resolution imaging of the epidermis and upper dermis. It is particularly suitable in the differential diagnosis of melanocytic lesions. Optical coherence tomography (OCT) has a lower resolution compared to confocal laser microscopy but a greater depth of penetration. It is primarily used for imaging epithelial skin cancer, especially in the context of monitoring the effectiveness of nonsurgical therapies. Electrical impedance spectroscopy does not yield cutaneous images but rather provides a score based on the cellular irregularity of the skin. Multispectral analysis involves illumination of the skin with different wavelengths and likewise results in the computation of a score. Both methods are used in the differentiation of dysplastic nevi from melanoma. Other diagnostic imaging and biophysical methods are currently still in the developmental stages.By increasing the sensitivity and specificity of clinical and dermoscopic findings, the aforementioned methods bring about an improvement in noninvasive diagnosis. They allow for skin lesions to be monitored over time and therapeutic effects to be quantified. Finally, they facilitate early diagnosis of skin cancer, and help avoid unnecessary surgery of benign lesions. In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy allows for high‐resolution imaging of the epidermis and upper dermis. It is particularly suitable in the differential diagnosis of melanocytic lesions. Optical coherence tomography (OCT) has a lower resolution compared to confocal laser microscopy but a greater depth of penetration. It is primarily used for imaging epithelial skin cancer, especially in the context of monitoring the effectiveness of nonsurgical therapies. Electrical impedance spectroscopy does not yield cutaneous images but rather provides a score based on the cellular irregularity of the skin. Multispectral analysis involves illumination of the skin with different wavelengths and likewise results in the computation of a score. Both methods are used in the differentiation of dysplastic nevi from melanoma. Other diagnostic imaging and biophysical methods are currently still in the developmental stages. By increasing the sensitivity and specificity of clinical and dermoscopic findings, the aforementioned methods bring about an improvement in noninvasive diagnosis. They allow for skin lesions to be monitored over time and therapeutic effects to be quantified. Finally, they facilitate early diagnosis of skin cancer, and help avoid unnecessary surgery of benign lesions. |
| Author | Welzel, Julia Schuh, Sandra |
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| Cites_doi | 10.1111/jdv.13596 10.1111/bjd.14516 10.1111/jdv.13569 10.1001/jamadermatol.2016.1188 10.1111/jdv.13712 10.1111/bjd.13121 10.1126/scitranslmed.aad1278 10.1111/bjd.13853 10.1111/ddg.12362 10.1159/000444706 |
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| Notes | EIS is suitable and designed for differentiating benign from malignant melanocytic lesions. One application of Raman spectroscopy is Indispensable in many cases, dermoscopy is the most important diagnostic tool; its significant role has been confirmed for a wide range of clinical situations. Multispectral analysis can be used as a screening tool in patients with multiple dysplastic nevi in order to detect any particularly conspicuous lesions. 20‐MHz ultrasound is still occasionally used for measuring tumor thickness and for monitoring the course of connective tissue disorders. Based on epidermal thickness, signal intensity, and the aforementioned morphological criteria, OCT allows for highly accurate distinction between actinic keratosis and basal cell carcinoma. CLM is primarily used in the differential diagnosis of pigmented lesions. While confocal laser microscopy has become an established modality in the diagnosis of melanocytic lesions, optical coherence tomography is routinely used in the diagnosis of basal cell carcinoma. From these curves, the system calculates a score that reflects the degree of abnormality of the lesion. in vivo Apart from structural imaging based on reflection, fluorescence diagnostics allow for the visualization of specific structures by adding exogenous fluorecent dyes. OCT provides real‐time cross‐sectional images of the skin with a penetration depth of 1 to 1.5 mm and a resolution of less than 10 μm. OCT is primarily used in the diagnosis of epithelial skin tumors, in particular basal cell carcinoma. A further technical advancement, dynamic OCT allows for simultaneous visualization of superficial blood vessels. Large studies have shown that CLM allows for more accurate detection of initial melanomas than dermoscopy and, in particular, for the distinction between dysplastic nevi and melanoma. The contrast in the CLM images is due to differences in reflection intensity. detection of antioxidants in the skin. Optical coherence tomography is primarily employed in the diagnosis of basal cell carcinoma. In dermatology, multispectral optoacoustic tomography has already been used in pilot studies on the detection and noninvasive diagnosis of sentinel lymph nodes. Multiphoton tomography does not only display structural changes but also provides information on physiological and pathophysiological (functional) processes in the skin. The penetration depth of the signal is insufficient to determine the extent of tumor invasion. Electrical impedance spectroscopy is not an imaging method but rather yields a score that indicates the degree of cellular heterogeneity. Due to the moving blood flow, blood vessels appear as a color‐coded red network on dynamic OCT (horizontal view). In dermatofluoroscopy, imaging is based on the specific self‐fluorescence of melanin in melanosomes. Confocal laser microscopy enables high‐resolution, noninvasive, real‐time imaging of the epidermis and upper dermis at cellular resolution. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Feature-1 ObjectType-Review-3 content type line 23 |
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| References | 2015; 173 2016; 30 2016; 232 2014; 171 2015; 7 2016; 175 2014; 12 2016; 152 2016; 34 e_1_2_18_2_1 e_1_2_18_10_1 e_1_2_18_4_1 Welzel J (e_1_2_18_5_1) 2016; 34 Hauschild A (e_1_2_18_11_1) 2014; 12 e_1_2_18_12_1 e_1_2_18_3_1 e_1_2_18_6_1 e_1_2_18_8_1 e_1_2_18_7_1 e_1_2_18_9_1 |
| References_xml | – volume: 12 start-page: 606 year: 2014 end-page: 14 article-title: To excise or not: impact of MelaFind on German dermatologists’ decisions to biopsy atypical lesions publication-title: J Dtsch Dermatol Ges – volume: 7 start-page: 317ra199 year: 2015 article-title: Metastatic status of sentinel lymph nodes in melanoma determined noninvasively with multispectral optoacoustic imaging publication-title: Sci Transl Med – volume: 30 start-page: 1295 year: 2016 end-page: 302 article-title: A meta‐analysis of reflectance confocal microscopy for the diagnosis of malignant skin tumours publication-title: J Eur Acad Dermatol Venereol – volume: 173 start-page: 428 year: 2015 end-page: 35 article-title: The sensitivity and specificity of optical coherence tomography for the assisted diagnosis of nonpigmented basal cell carcinoma: an observational study publication-title: Br J Dermatol – volume: 30 start-page: 1321 year: 2016 end-page: 6 article-title: Optical coherence tomography of actinic keratoses and basal cell carcinomas – differentiation by quantification of signal intensity and layer thickness publication-title: J Eur Acad Dermatol Venereol – volume: 232 start-page: 298 year: 2016 end-page: 311 article-title: Dynamic Optical Coherence Tomography in Dermatology publication-title: Dermatology – volume: 30 start-page: 974 year: 2016 end-page: 9 article-title: In vivo micro‐morphological vascular changes induced by topical brimonidine studied by dynamic optical coherence tomography publication-title: J Eur Acad Dermatol Venereol – volume: 175 start-page: 364 year: 2016 end-page: 74 article-title: Multicentre study on inflammatory skin diseases from The International Confocal Working Group: specific confocal microscopy features and an algorithmic method of diagnosis publication-title: Br J Dermatol – volume: 152 start-page: 1093 year: 2016 end-page: 8 article-title: Clinical indications for use of reflectance confocal microscopy for skin cancer diagnosis publication-title: JAMA Dermatol – volume: 34 start-page: 527 year: 2016 end-page: 33 article-title: Fluorescence (Multiwave) Confocal Microscopy publication-title: Dermatol – volume: 171 start-page: 1099 year: 2014 end-page: 107 article-title: Clinical performance of the Nevisense system in cutaneous melanoma detection: an international, multicentre, prospective and blinded clinical trial on efficacy and safety publication-title: Br J Dermatol – ident: e_1_2_18_9_1 doi: 10.1111/jdv.13596 – ident: e_1_2_18_4_1 doi: 10.1111/bjd.14516 – ident: e_1_2_18_7_1 doi: 10.1111/jdv.13569 – ident: e_1_2_18_3_1 doi: 10.1001/jamadermatol.2016.1188 – volume: 34 start-page: 527 year: 2016 ident: e_1_2_18_5_1 article-title: Fluorescence (Multiwave) Confocal Microscopy publication-title: Dermatol – ident: e_1_2_18_2_1 doi: 10.1111/jdv.13712 – ident: e_1_2_18_10_1 doi: 10.1111/bjd.13121 – ident: e_1_2_18_12_1 doi: 10.1126/scitranslmed.aad1278 – ident: e_1_2_18_6_1 doi: 10.1111/bjd.13853 – volume: 12 start-page: 606 year: 2014 ident: e_1_2_18_11_1 article-title: To excise or not: impact of MelaFind on German dermatologists’ decisions to biopsy atypical lesions publication-title: J Dtsch Dermatol Ges doi: 10.1111/ddg.12362 – ident: e_1_2_18_8_1 doi: 10.1159/000444706 |
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In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy... In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy allows for... Summary In addition to dermoscopy, there are other imaging and biophysical methods for the noninvasive diagnosis of skin lesions. Confocal laser microscopy... |
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| SubjectTerms | Biopsy Dermis Dermoscopy - methods Developmental stages Diagnosis Diagnosis, Differential Dielectric Spectroscopy - methods Differential diagnosis Dysplastic Nevus Syndrome - diagnostic imaging Dysplastic Nevus Syndrome - pathology Electrical impedance Epidermis Humans Medical imaging Melanoma Melanoma - diagnostic imaging Melanoma - pathology Microscopy Microscopy, Confocal - methods Sensitivity and Specificity Skin - diagnostic imaging Skin - pathology Skin cancer Skin diseases Skin Diseases - diagnostic imaging Skin Diseases - pathology Skin Neoplasms - diagnostic imaging Skin Neoplasms - pathology Spectroscopy Surgery Tomography, Optical Coherence - methods |
| Title | Noninvasive diagnosis in dermatology |
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