Abstract
High-definition optical coherence tomography (HD-OCT) is a non-invasive technique for morphological investigation of tissue with cellular resolution filling the imaging gap between reflectance confocal microscopy and conventional optical coherence tomography. The aim of this study is first to correlate dermatopathologic descriptors of inflammatory skin conditions with epidermal alteration to features observed by HD-OCT. Secondly, to assess the discriminative accuracy of common inflammatory reaction patterns with epidermal alteration using HD-OCT by applying Ackerman’s algorithmic method of pattern recognition. The generated HD-OCT images of 160 patients presenting an inflammatory skin disease were analyzed with respect to the following criteria: visualization of individual cells in the epidermis and dermis and morphology of dermo-epidermal junction, papillary dermis and reticular dermis. A set of morphological features corresponding to dermatopathological descriptors are obtained and the discriminative accuracy of HD-OCT of inflammatory reaction patterns could be demonstrated. These patterns are spongiotic dermatitis, psoriasiform dermatitis, interface dermatitis and ballooning dermatitis. Additional studies to test the sensitivity and specificity of the proposed algorithm for pattern analysis are essential. The other categories of Ackerman’s pattern recognition need to be evaluated. This study provides a set of morphological features generated by HD-OCT imaging very similar to those described for reflectance confocal microscopy but with the advantages not only to visualize individual cells up to a depth of 570 μm but also in both slice and en face mode. An adapted algorithmic method for pattern analysis of common inflammatory skin diseases could be proposed. This new technique appears to be a promising method for non-invasive diagnosis, evaluation and management of common inflammatory skin diseases.
Highlights
Most dermatological diseases were originally defined morphologically, and terms such as papules and pustules are still important when diagnosing skin disease
The aim of this study is first to correlate dermatopathologic descriptors of inflammatory skin conditions with epidermal alteration to features observed by High-definition optical coherence tomography (HD-OCT)
The generated HD-OCT images of 160 patients presenting an inflammatory skin disease were analyzed with respect to the following criteria: visualization of individual cells in the epidermis and dermis and morphology of dermo-epidermal junction, papillary dermis and reticular dermis
Summary
Most dermatological diseases were originally defined morphologically, and terms such as papules and pustules are still important when diagnosing skin disease. Later dermatopathology evolved with its own special vocabulary of terms used to describe histological skin alterations, allowing dermatopathologists to classify skin diseases in great detail [21]. The initial approach is often to classify the changes broadly according to whether a process is predominantly inflammatory, predominantly proliferative/neoplastic, both inflammatory and proliferative or non-inflammatory/non-proliferative. The majority of pathologic processes can be classified into one of these groups, challenging exceptions occur, Arch Dermatol Res (2013) 305:283–297 when overlapping features appear [8]. Ackerman and colleagues [1] defined eight basic patterns of inflammatory diseases of the skin, where the pattern strongly indicates diagnosis prior to more detailed studies
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