Dryżałowska Zuzanna, Blicharz Leszek, Michalczyk Agnieszka, Koscian Jan, Maj Małgorzata, Czuwara Joanna, Rudnicka Lidia
Department of Dermatology, Medical University of Warsaw, 02-088 Warsaw, Poland.
Diagnostics (Basel). 2024 Aug 8;14(16):1724. doi: 10.3390/diagnostics14161724.
Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. Due to its high prevalence, considerable morbidity, and chronicity, there is a need for the accurate in vivo evaluation of treatment efficacy. Line-field confocal optical coherence tomography (LC-OCT) is a new emerging imaging technique able to perform a non-invasive, real-time examination of the epidermis and the upper dermis. LC-OCT may represent a promising tool in the diagnosis and treatment follow-up of chronic eczematous skin diseases with barrier defects.
We aimed to investigate the role of LC-OCT in the non-invasive monitoring of the treatment effect on five patients with severe atopic dermatitis during dupilumab treatment.
LC-OCT imaging was performed on five patients (three women and two men) aged between 14 and 85 years old at the baseline and at 2, 4, and 6 weeks of treatment with dupilumab. The LC-OCT scans were performed at two sites, the lesional skin in the antecubital fossa and the extensor part of the arm, considered a control site on each patient for comparison. The captured images were later evaluated. Descriptive statistics and a -test were used to compare the analyzed parameters over time and between involved atopic skin and clinically healthy skin.
The LC-OCT imaging was able to detect the difference in stratum corneum (SC) thickness and quality and epidermal thickness (ET) and the changes before and after treatment with high accuracy. The main findings include a significant reduction in the epidermal and stratum corneum thickness and decreased epidermal spongiosis and inflammation, with better quality of the stratum corneum indicating restoration of its tightness at both lesional and control sites.
This study demonstrates that clinical improvement of affected and unaffected atopic skin under dupilumab treatment correlates with the LC-OCT findings. LC-OCT represents a novel, non-invasive tool examining the in vivo skin barrier and inflammation and can help to monitor the treatment efficacy among patients with atopic dermatitis in daily practice.
特应性皮炎（AD）是最常见的慢性炎症性皮肤病。由于其高患病率、相当高的发病率和慢性病程，需要对治疗效果进行准确的体内评估。线场共聚焦光学相干断层扫描（LC-OCT）是一种新兴的成像技术，能够对表皮和真皮上层进行非侵入性实时检查。LC-OCT可能是诊断和随访有屏障缺陷的慢性湿疹性皮肤病的一种有前景的工具。
我们旨在研究LC-OCT在度普利尤单抗治疗5例重度特应性皮炎患者过程中对治疗效果进行非侵入性监测的作用。
对5例年龄在14至85岁之间的患者（3名女性和2名男性）在基线时以及度普利尤单抗治疗的第2、4和6周进行LC-OCT成像。LC-OCT扫描在两个部位进行，即肘前窝的皮损皮肤和手臂伸侧部位，将其作为每位患者的对照部位进行比较。随后对采集的图像进行评估。使用描述性统计和t检验来比较分析参数随时间的变化以及受累特应性皮肤与临床健康皮肤之间的差异。
LC-OCT成像能够高精度地检测角质层（SC）厚度和质量以及表皮厚度（ET）的差异以及治疗前后的变化。主要发现包括表皮和角质层厚度显著降低，表皮海绵形成和炎症减轻，角质层质量改善表明其紧致度在皮损部位和对照部位均得以恢复。
本研究表明，度普利尤单抗治疗下受累和未受累特应性皮肤的临床改善与LC-OCT检查结果相关。LC-OCT是一种新型的非侵入性工具，可用于检查体内皮肤屏障和炎症，有助于在日常实践中监测特应性皮炎患者的治疗效果。
