Department of Dermatology, Bispebjerg Hospital, Nielsine Nielsens Vej 9, 2400 København NV, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
DTU Fotonik, Department of Photonics Engineering, Technical University of Denmark, Kongens Lyngby, Denmark.
J Biophotonics. 2019 Jun;12(6):e201800462. doi: 10.1002/jbio.201800462. Epub 2019 Apr 14.
Distinction between normal skin and pathology can be a diagnostic challenge. This systematic review summarizes how various contrast agents, either topically delivered or injected into the skin, affect distinction between skin disease and normal skin when imaged by optical coherence tomography (OCT) and confocal microscopy (CM). A systematic review of in vivo OCT and CM studies using exogenous contrast agents on healthy human skin or skin disease was performed. In total, nine CM studies and one OCT study were eligible. Four contrast agents aluminum chloride (AlCl) n = 2, indocyanine green (ICG) n = 3, sodium fluorescein n = 3 and acetic acid n = 1 applied to CM in variety of skin diseases. ICG, acetic acid and AlCl showed promise to increase contrast of tumor nests in keratinocyte carcinomas. Fluorescein and ICG enhanced contrast of keratinocytes and adnexal structures. In OCT of healthy skin gold nanoshells, increased contrast of natural skin openings. Contrast agents may improve delineation and diagnosis of skin cancers; ICG, acetic acid and AlCl have potential in CM and gold nanoshells facilitate visualization of adnexal skin structures in OCT. However, as utility of bedside optical imaging increases, further studies with robust methodological quality are necessary to implement contrast agents into routine dermatological practice.
正常皮肤与病变皮肤的区分可能具有诊断挑战性。本系统综述总结了各种对比剂（无论是局部递送至皮肤还是注射到皮肤内）如何在光学相干断层扫描（OCT）和共聚焦显微镜（CM）成像时影响皮肤疾病与正常皮肤的区分。对使用外源性对比剂在健康人皮肤或皮肤疾病上进行的 OCT 和 CM 体内研究进行了系统综述。共有 9 项 CM 研究和 1 项 OCT 研究符合条件。4 种对比剂（三氯化铝（AlCl）n=2，吲哚菁绿（ICG）n=3，荧光素钠 n=3，乙酸 n=1）应用于各种皮肤疾病的 CM。ICG、乙酸和 AlCl 有望增加角化细胞癌肿瘤巢的对比度。荧光素和 ICG 增强了角质细胞和附属结构的对比度。在健康皮肤的 OCT 中，金纳米壳增加了自然皮肤开口的对比度。对比剂可能改善皮肤癌的描绘和诊断；ICG、乙酸和 AlCl 在 CM 中有潜力，金纳米壳有助于 OCT 中观察附属皮肤结构。然而，随着床边光学成像的应用增加，需要进行具有稳健方法学质量的进一步研究，以将对比剂纳入常规皮肤科实践。
