Orsini C, Trovato E, Cortonesi G, Pedrazzani M, Suppa M, Rubegni P, Tognetti L, Cinotti E
Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy.
DAMAE Medical, Paris, France.
J Eur Acad Dermatol Venereol. 2024 Feb;38(2):325-331. doi: 10.1111/jdv.19568. Epub 2023 Oct 17.
Line-field confocal optical coherence tomography (LC-OCT) is a new, valid means for a rapid and non-invasive in vivo examination of the epidermis and upper dermis, allowing digital interpretation and measurement of high-resolution images on a cellular level. Given these properties, it may represent a valid tool for monitoring psoriasis during treatment, allowing a new method to set a precise objective severity of the disease.
We aimed to investigate the potentialities of LC-OCT in the non-invasive monitoring of microscopical changes associated with moderate-severe plaque psoriasis (PP) during the treatment with the most common biological drugs.
We performed LC-OCT imaging of PP lesions from 17 patients before and after 8 weeks of treatment. The clinical severity of the single lesions was evaluated using a lesion score (LS), designed considering three parameters: erythema, desquamation and infiltration. LC-OCT images were segmented by artificial intelligence and evaluated based on three microscopic criteria: the thickness of the stratum corneum, the thickness of the living epidermis and the undulation of the dermo-epidermal junction.
Line-field confocal optical coherence tomography digital analysis allowed recognition and quantification of the three microscopic criteria, showing a reduction of all these during the follow-up. Furthermore, a high correlation between change in LS and the thickness of the stratum corneum and the thickness of the living epidermis was found.
Line-field confocal optical coherence tomography can non-invasively monitor the response of PP to different treatments. Morphometric changes occurring in the psoriatic lesion during the 8-week treatment period were identified by in vivo LC-OCT and measured by using artificial intelligence. Although future studies are required, based on these preliminary results, LC-OCT may represent a valid potential tool for precise monitoring of therapeutic response.
线场共聚焦光学相干断层扫描（LC-OCT）是一种用于对表皮和真皮上层进行快速、非侵入性活体检查的新型有效手段，能够在细胞水平对高分辨率图像进行数字解读和测量。鉴于这些特性，它可能是治疗期间监测银屑病的有效工具，从而提供一种确定疾病精确客观严重程度的新方法。
我们旨在研究LC-OCT在使用最常见生物药物治疗中度至重度斑块状银屑病（PP）期间对相关微观变化进行非侵入性监测的潜力。
我们对17例患者的PP皮损在治疗8周前后进行了LC-OCT成像。使用皮损评分（LS）评估单个皮损的临床严重程度，该评分考虑了三个参数：红斑、脱屑和浸润。LC-OCT图像通过人工智能进行分割，并基于三个微观标准进行评估：角质层厚度、活表皮厚度和真皮-表皮交界处的起伏。
线场共聚焦光学相干断层扫描数字分析能够识别和量化这三个微观标准，显示在随访期间所有这些标准均有所降低。此外，还发现LS变化与角质层厚度和活表皮厚度之间存在高度相关性。
线场共聚焦光学相干断层扫描可以非侵入性地监测PP对不同治疗的反应。在8周治疗期间银屑病皮损中发生的形态计量学变化通过活体LC-OCT得以识别，并使用人工智能进行测量。尽管需要进一步的研究，但基于这些初步结果，LC-OCT可能是精确监测治疗反应的有效潜在工具。
