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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| Veröffentlicht in: | Journal der Deutschen Dermatologischen Gesellschaft Jg. 15; H. 10; S. 999 - 1016 |
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| Hauptverfasser: | , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
Germany
Wiley Subscription Services, Inc
01.10.2017
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| Schlagworte: | |
| ISSN: | 1610-0379, 1610-0387, 1610-0387 |
| Online-Zugang: | Volltext |
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| Zusammenfassung: | 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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| Bibliographie: | 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 |
| ISSN: | 1610-0379 1610-0387 1610-0387 |
| DOI: | 10.1111/ddg.13347 |