Abstract
Laser speckle contrast analysis (LASCA) is a non-contact technique able to quantify peripheral blood perfusion (PBP) over large skin areas. LASCA has been used to study hand PBP in several clinical conditions. These include systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) and LASCA showed that PBP was significantly lower in these conditions than in healthy subjects (HS). Moreover, it has been demonstrated that LASCA is a safe technique also able to monitor digital ulcer perfusion and their evolution in SSc patients, during systemic and local treatment. The use of LASCA, coupled with reactivity tests is commonplace in the field of microvascular function research. Post-occlusive hyperemia reactivity (POHR) and local thermal hyperemia, associated with laser techniques are reliable tests in the evaluation of perfusion in SSc patients. Other studies used laser speckled techniques, together with acetylcholine and sodium nitroprusside iontophoresis, as specific tests of endothelium function. In conclusion, LASCA is a safe, non-contact reliable instrument for the quantification of PBP at skin level and can also be associated with reactivity tests to monitor disease progression and response to treatment in different connective tissue diseases.
Highlights
This review aims at updating information on the new acquisition regarding the laser speckle techniques in the study of functional microvascular alterations in connective tissue diseases for the diagnosis, follow-up and management of treatment in these complex conditions
Skin peripheral blood perfusion (PBP) was analyzed by laser speckle contrast analysis (LASCA) at the level of dorsum of the middle phalanx of the third fingers, dorsal aspect of the hands and zygoma The dermal thickness (DT) was assessed by both skin high frequency ultrasound (US) and modified Rodnan skin score (mRSS) in the same above reported areas
This study demonstrates that aminaphtone is able to increase skin BP and improve the clinical symptoms of Raynaud’s Phenomenon (RP), with sustained efficacy of up to 6 months, even in patients with systemic sclerosis (SSc) (Ruaro et al, 2018b, 2019c)
Summary
Microvascular dysfunction is a key component in several connective tissue diseases, including systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) and has important clinical implications, e.g., Raynaud’s Phenomenon (RP) (Lin et al, 2004; Minier et al, 2014; Sebastiani et al, 2014; Bruni et al, 2018; Cutolo et al, 2018; Smith et al, 2018; Tamirou et al, 2018; Meroni and Tsokos, 2019; Saygin et al, 2019). Nailfold videocapillaroscopy (NVC) is a validated method to assess peripheral microangiopathy at the nailfold level, whilst laser speckle contrast analysis (LASCA) allows for a functional evaluation of peripheral microcirculation over large skin areas (Wigley et al, 1990; Roustit and Cracowski, 2012; Sulli et al, 2014a; Wigley and Flavahan, 2016; Ruaro et al, 2018a; Shirazi et al, 2021). They evaluated different face areas, i.e., the forehead, nose tip, zygomas and perioral region and the dorsal and volar aspects of hands Their data confirmed a significantly lower PBP in SSc patients than in HS at the fingertips, in periungual areas and the palms of the hands but not at the level of the dorsum of hands, whole face and the different facial areas (Sulli et al, 2014b; Ruaro et al, 2016). LSCI and thermography had a good reliability after the reperfusion/rewarming test
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