Imaging of desmoplastic trichoepithelioma by high-definition optical coherence tomography

Desmoplastic trichoepithelioma (DTE) is a rare benign adnexal tumor with follicular differentiation that appears most frequently on the face of young women. It can clinically mimic a variety of skin tumors such as intradermal nevus, sebaceous hyperplasia, and basal cell carcinoma (BCC).1 Because of its overlapping clinical features, the diagnosis of DTE is usually established on histopathology. However, given the predilection of DTE on cosmetically sensitive areas on the face, the indication for biopsy should be as accurate as possible. Several noninvasive imaging techniques have emerged in recent years, aiming for higher accuracy of in vivo diagnosis. These include dermoscopy, reflectance confocal microscopy (RCM), and conventional optical coherence tomography (OCT). High-definition (HD) OCT (Skintell; Agfa HealthCare, Brussels, Belgium) is a recently introduced technique based on the same principles of conventional OCT but differing on its ability to give optical imaging up to 570 \u3bcm deep within the skin, with high resolution of 3 \u3bcm both in axial and lateral directions. The field of view is 1.8 7 1.5 mm, and the total light power at the tissue is less than 3.5 mW. The system works in direct contact with the skin. The interference signal detected by the 2-dimensional imaging sensor is digitized, subsequently transferred to a computer, and displayed through a grayscale or color palette resulting in an OCT image. High-definition OCT is capable of capturing not only slice but also en face images in real time and fast 3-dimensional acquisition. Therefore, HD-OCT allows in vivo examination of the skin, enabling visualization of individual cells with a greater depth than RCM. It also provides cross-sectional imaging like the conventional OCT. Additional technical details are discussed elsewhere. View on Journal Site Related Articles Imaging of Desmoplastic Trichoepithelioma by High-Definition Optical Coherence Tomography Dermatologic Surgery 2015; 41(4): 522\u2013525. MULTIMODALITY IMAGING OF TORPEDO MACULOPATHY WITH SWEPT-SOURCE, EN FACE OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY Retinal Cases & Brief Reports 2018; 12(2): 153\u2013157. Optical Coherence Tomography: Future Applications in Cerebrovascular Imaging Stroke 2018; 49(4): 1044\u20131050

Dermoscopy, reflectance confocal microscopy and immunohistochemical analysis in melanocytic lesions with Meyerson's phenomenon

BACKGROUND: Meyerson's phenomenon is characterized by a symmetrical halo of erythema and scale around central, mostly melanocytic lesions. OBJECTIVE: Our aim was to describe the dermoscopic and reflectance confocal microscopy (RCM) features of melanocytic tumors less frequently associated with Meyerson's phenomenon, with histopathology and immunohistochemistry correlation. METHODS: Clinical, dermoscopic and RCM images of 4 histopathologically confirmed melanocytic tumors associated with Meyerson's phenomenon (3 dysplastic compound nevi and 1 melanoma) were retrospectively collected, with additional immunohistochemical analysis. RESULTS: RCM showed in vivo features of both melanocytic and spongiotic nature of the lesion associated with Meyerson's phenomenon, even in cases with absent halo. Our study also supported the involvement of immune-mediated CD4+ T lymphocyte mechanisms and Langerhans cells. CONCLUSION: Our case series supports the potential of RCM in the evaluation of tumoral and inflammatory skin diseases. RCM features of rare Meyerson's melanoma were also described for the first time. \ua9 2014 S. Karger AG, Basel