The role of androgens and estrogens in Hidradenitis Suppurativa – a Systematic Review

Hidradenitis suppurativa (HS) is an inflammatory skin disease. Several observations imply that sex hormones may play a role in its pathogenesis. HS is more common in women, and the disease severity appears to vary in intensity according to the menstrual cycle. In addition, parallels have been drawn between HS and acne vulgaris, suggesting that sex hormones may play a role in the condition. The role of androgens and estrogens in HS has therefore been explored in numerous observational and some interventional studies; however, the studies have often reported conflicting results. This systematic review includes 59 unique articles and aims to give an overview of the available research. Articles containing information on natural variation, severity changes during menstruation and pregnancy, as well as articles on serum levels of hormones in patients with HS and the therapeutic options of hormonal manipulation therapy have all been included and are presented in this systematic review. Our results show that patients with HS do not seem to have increased levels of sex hormones and that their hormone levels lie within the normal range. While decreasing levels of progesterone and estrogen seem to coincide with disease flares in premenopausal women, the association is speculative and requires experimental confirmation. Antiandrogen treatment could be a valuable approach in treating HS, however randomized control trials are lacking.</p

In-vivo-Darstellung einer Sarcoptes-scabiei-Infestation mittels optischer Kohärenztomographie

&lt;b&gt;&lt;i&gt;Hintergrund: &lt;/i&gt;&lt;/b&gt;&lt;i&gt;Sarcoptes scabiei&lt;/i&gt; kann mit Hilfe verschiedener Darstellungsverfahren sichtbar gemacht werden. Mit der optischen Kohärenztomographie (OCT) lassen sich möglicherweise die bei Skabies-Infestation auftretenden Veränderungen der Hautmorphologie charakterisieren und der Parasit darstellen. &lt;b&gt;&lt;i&gt;Methoden:&lt;/i&gt;&lt;/b&gt; Fünf Patienten aus der Klinik für Dermatologie am Klinikum Augsburg und am Roskilde Hospital in Roskilde, Dänemark, wurden mit der optischen Kohärenztomographie (OCT; VivoSight®; Michelson Diagnostics Ltd., UK) untersucht. Der Nachweis der Milben erfolgte mittels Epilumineszenz; zur Bestätigung der Diagnose wurde eine lichtmikroskopische Untersuchung durchgeführt. &lt;b&gt;&lt;i&gt;Ergebnisse:&lt;/i&gt;&lt;/b&gt; Die OCT wies in vivo bei allen Patienten &lt;i&gt;S.-scabiei&lt;/i&gt;-Milben nach. Milben und Gänge wurden sichtbar gemacht und Einzelheiten des Ganginhalts dargestellt. &lt;b&gt;&lt;i&gt;Schlussfolgerung:&lt;/i&gt;&lt;/b&gt; Die OCT kann &lt;i&gt;S.-scabiei&lt;/i&gt;-Milben in vivo sichtbar machen, was dafür spricht, dass die OCT zur Untersuchung der Biologie der Milbe in vivo eingesetzt werden kann und eine frühzeitige Beurteilung einer gegen Krätzmilben wirkenden Therapie ermöglicht. Die OCT ist in der Lage, Strukturen in der Haut mit einer Auflösung von 8 µm darzustellen. Somit könnte dieses Verfahren eine rasche, nichtinvasive, In-vivo-Diagnose und -Untersuchung von Infestationen ermöglichen.</jats:p

Dynamic Optical Coherence Tomography in Dermatology

Optical coherence tomography (OCT) represents a non-invasive imaging technology, which may be applied to the diagnosis of non-melanoma skin cancer and which has recently been shown to improve the diagnostic accuracy of basal cell carcinoma. Technical developments of OCT continue to expand the applicability of OCT for different neoplastic and inflammatory skin diseases. Of these, dynamic OCT (D-OCT) based on speckle variance OCT is of special interest as it allows the in vivo evaluation of blood vessels and their distribution within specific lesions, providing additional functional information and consequently greater density of data. In an effort to assess the potential of D-OCT for future scientific and clinical studies, we have therefore reviewed the literature and preliminary unpublished data on the visualization of the microvasculature using D-OCT. Information on D-OCT in skin cancers including melanoma, as well as in a variety of other skin diseases, is presented in an atlas. Possible diagnostic features are suggested, although these require additional validation

Dynamic optical coherence tomography of blood vessels in cutaneous melanoma — correlation with histology, immunohistochemistry and dermoscopy

Dermoscopy adds important information to the assessment of cutaneous melanoma, but the risk of progression is predicted by histologic parameters and therefore requires surgery and histopathologic preparation. Neo-vascularization is crucial for tumor progression and worsens prognosis. The aim of this study was the in vivo evaluation of blood vessel patterns in melanoma with dynamic optical coherence tomography (D-OCT) and the correlation with dermoscopic and histologic malignancy parameters for the risk assessment of melanoma. In D-OCT vessel patterns, shape, distribution and presence/type of branching of 49 melanomas were evaluated in vivo at three depths and correlated with the same patterns in dermoscopy and with histologic parameters after excision. In D-OCT, blood vessel density and atypical shapes (coils and serpiginous vessels) increased with higher tumor stage. The histologic parameters ulceration and Hmb45- and Ki67-positivity increased, whereas regression, inflammation and PD-L1-positivity decreased with risk. CD31, VEGF and Podoplanin correlated with D-OCT vasculature findings. B-RAF mutation status had no influence. Due to pigment overlay and the summation effect, the vessel evaluation in dermoscopy and D-OCT did not correlate well. In summary, atypical vessel patterns in melanoma correlate with histologic parameters for risk for metastases. Tumor vasculature can be noninvasively assessed using D-OCT before surgery

Imaging blood vessel morphology in skin: dynamic optical coherence tomography as a novel potential diagnostic tool in dermatology

Conventional optical coherence tomography (OCT) enables the visualization of morphological changes of skin cancer. The use of OCT in the diagnostic investigation and in the therapy decision of non-melanoma skin cancer and other skin changes is already established, and has found its way into routine practice. With the development of speckle-variance OCT, also named dynamic OCT (D-OCT), the vascular architecture and the blood flow of the skin can be displayed in vivo and in 3D. This novel angiographic variant of OCT offers the ability to visualize and measure vessel morphology providing a new insight into healthy, inflammatory and neoplastic skin lesions such as malignant melanoma. This review focuses on the possibilities of using D-OCT on healthy and diseased skin. We suggest and illustrate key diagnostic characteristics by analyzing the initial publications and preliminary unpublished data on vessel morphology and distribution. The potential of D-OCT as a diagnostic tool in dermatology is examined and may give rise to future studies on D-OCT, which are needed to confirm the aforementioned features