使用多模态光学相干断层扫描评估分次二氧化碳激光治疗硬化性苔藓后皮肤的恢复情况。
Evaluation of Skin Recovery after Fractional CO Laser Treatment Lichen Sclerosus Using Multimodal Optical Coherence Tomography.
作者信息
Sirotkina M A, Potapov A L, Loginova M M, Bychkova A E, Moiseev A A, Kochuyeva M V, Bogomolova A Yu, Kiseleva E B, Asaturova A V, Maslennikova A V, Radenska-Lopovok S G, Apolikhina L A, Gladkova N D
机构信息
PhD, Director, Research Institute of Experimental Oncology and Biomedical Technologies; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.
Laboratory Assistant, Laboratory of Optical Coherence Tomography, Research Institute of Experimental Oncology and Biomedical Technologies; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.
出版信息
Sovrem Tekhnologii Med. 2024;16(4):15-26. doi: 10.17691/stm2024.16.4.02. Epub 2024 Aug 30.
UNLABELLED
is to demonstrate the effect of fractional CO laser treatment on vulvar skin in lichen sclerosus using multimodal optical coherence tomography (MM OCT).
MATERIALS AND METHODS
The study included 3 clinical cases of vulvar lichen sclerosus (VLS) (histologically classified as early, early with dermal edema, late) and 2 control cases without vulvar pathology. Patients with VLS underwent 3 procedures of fractional CO laser treatment with an interval of 30-40 days. In patients without vulvar pathology, the MM OCT examination was performed once, in patients with VLS it was done at the point of the greatest visible skin damage just before a punch biopsy, immediately after the first laser session, and 1 month after a full course of treatment.
RESULTS
Analyzing the case series of vulvar skin recovery 1 month after fractional CO laser treatment, it has been found that the recovery depended on the dermal condition before the treatment. In early VLS and early VLS with dermal edema (clinical cases 1 and 2) before the treatment, the MM OCT examination has shown a decreased epidermal thickness, unclear contrast between the epidermis and dermis, a decrease in the values of the OCT signal attenuation coefficient in the dermis, and a sharp reduction in the density of blood and lymphatic vessels. After treatment, the MM OCT examination demonstrated a complete recovery of vulvar skin structure and all quantitative values reached the level characteristic of normal vulvar skin. Before the treatment, a homogenization zone (sclerosis) was clearly visible in the MM OCT images of the dermis in late VLS (clinical case 3). After the treatment, complete recovery of the vulvar skin structure was not observed; the area of sclerosis was preserved; however, visually, there was an increase in the density of blood and lymphatic vessels in the affected area, which almost reached the level of normal vulvar skin.
CONCLUSION
MM OCT can be proposed as a promising non-invasive method for monitoring skin recovery after fractional CO laser treatment of VLS.
未标注
旨在使用多模态光学相干断层扫描（MM OCT）证明分次二氧化碳激光治疗对外阴硬化性苔藓外阴皮肤的影响。
材料与方法
该研究纳入了3例外阴硬化性苔藓（VLS）临床病例（组织学分类为早期、伴有真皮水肿的早期、晚期）和2例无外阴病变的对照病例。VLS患者接受了3次分次二氧化碳激光治疗，间隔30 - 40天。无外阴病变的患者进行了1次MM OCT检查，VLS患者在打孔活检前皮肤损伤最明显处、首次激光治疗后立即以及整个疗程治疗后1个月进行检查。
结果
分析分次二氧化碳激光治疗后1个月外阴皮肤恢复的病例系列发现，恢复情况取决于治疗前的真皮状况。治疗前早期VLS和伴有真皮水肿的早期VLS（临床病例1和2），MM OCT检查显示表皮厚度降低、表皮与真皮之间对比度不清晰、真皮中OCT信号衰减系数值降低以及血液和淋巴管密度急剧降低。治疗后，MM OCT检查显示外阴皮肤结构完全恢复，所有定量值达到正常外阴皮肤的特征水平。治疗前，晚期VLS（临床病例3）的真皮MM OCT图像中可见明显的均质化区域（硬化）。治疗后，未观察到外阴皮肤结构完全恢复；硬化区域仍然存在；然而，肉眼可见，受累区域血液和淋巴管密度增加，几乎达到正常外阴皮肤水平。
结论
MM OCT可作为一种有前景的非侵入性方法，用于监测分次二氧化碳激光治疗VLS后皮肤的恢复情况。
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