Abrouk Michael, Gianatasio Chloe, Li Yumeng, Holmes Jon, Dong Joanna, Quiñonez Rebecca L, Waibel Jill S
Dr. Abrouk, Dr. Li, and Dr. Dong are with the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine in Miami, Florida.
Ms. Gianatasio, Dr. Holmes, Dr. Quinoñez, and Dr. Waibel are with the Miami Dermatology and Laser Institute in Miami, Florida.
J Clin Aesthet Dermatol. 2022 Sep;15(9):30-39.
When using laser therapy to effectively treat scars, the choice of treatment parameters depends on the knowledge accuracy of the underlying scar pathology, which is often difficult to judge by gross physical exam. As such, more quantitative measures are needed. In recent years, optical coherencetomography (OCT) has shown promise as a real-time imaging technolgoy of skin microstructure. A key step in developing a methodology for utilizing OCT to develop a comprehensive 'atlas' of OCT characteristics of a wide variety of scar types. This atlas may then be used as a tool for selecting the optimal treatment modality and parameters for each scar type.
One hundred and fifty scars of a wide range of anatomical locations were imaged using OCT, capturing both vascular and structural data. A variety of scar etiologies (e.g. burn, surgical, traumatic) and types (e.g. hypertrophic, keloidal, atrophic) were included. Comparator scans were also taken from normal, unscarred skin.
OCT revealed morphological differences in the epidermis and dermis between scars and normal tissue, and between scar subtypes. Features affected by scar pathology included epidermal thickness, skin surface texture, dermal epidermal junction rugosity, blood vessel density, vessel shape and diameter, vessel direction and vascular network, dermis scattering intensity and non-uniformity. Each scar subtype showed consistent characteristics distinct from other scar subtypes.
This was a single-site study of a patient population in South Florida.
OCT is a powerful new objective tool for the clinician to utilize in the pursuit of effective laser treatment parameters by enabling personalized treatment based on individual scar characteristics in order to maximize treatment capabilities.
在使用激光疗法有效治疗瘢痕时，治疗参数的选择取决于对潜在瘢痕病理的了解准确性，而这通常很难通过肉眼体格检查来判断。因此，需要更多的定量测量方法。近年来，光学相干断层扫描（OCT）已显示出作为皮肤微观结构实时成像技术的潜力。开发一种利用OCT为各种瘢痕类型建立全面的OCT特征“图谱”的方法学的关键一步。然后，该图谱可作为为每种瘢痕类型选择最佳治疗方式和参数的工具。
使用OCT对150个位于广泛解剖位置的瘢痕进行成像，获取血管和结构数据。纳入了多种瘢痕病因（如烧伤、手术、创伤）和类型（如增生性、瘢痕疙瘩性、萎缩性）。还从正常未瘢痕化的皮肤进行了对照扫描。
OCT显示瘢痕与正常组织之间以及瘢痕亚型之间在表皮和真皮的形态学差异。受瘢痕病理影响的特征包括表皮厚度、皮肤表面纹理、真皮表皮连接粗糙度、血管密度、血管形状和直径、血管方向和血管网络、真皮散射强度和不均匀性。每种瘢痕亚型都显示出与其他瘢痕亚型不同的一致特征。
这是对南佛罗里达州患者群体的单中心研究。
OCT是一种强大的新客观工具，临床医生可利用它根据个体瘢痕特征进行个性化治疗，以追求有效的激光治疗参数，从而最大限度地提高治疗效果。
