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Abstract：
BACKGROUND: Topical application of gold microparticles (GMPs) for selective photothermolysis is a recently FDA-cleared therapy for acne vulgaris. Current evidence indicates the potential of optical imaging to non-invasively visualize GMPs and describe photothermal tissue effects.
OBJECTIVE: To qualitatively and quantitatively describe GMP delivery in vivo and visualize laser-mediated thermal effects of GMPs in facial skin of acne patients and healthy participants, using reflectance confocal microscopy (RCM) and optical coherence tomography (OCT).
METHODS: Patients with facial acne (n = 14), and healthy participants (n = 7) were included. RCM and OCT images were acquired at baseline, after GMP application, and after diode laser exposure. All images were evaluated qualitatively and quantitatively with regards to GMP delivery in skin layers and morphological thermal effects. Lastly, skin biopsies were obtained to compare RCM and OCT findings to histology.
RESULTS: GMPs were delivered equally in healthy participants and acne patients, and in lesional and non-lesional acne skin. In RCM images, GMPs appeared as hyperreflective aggregates inside hair follicles and eccrine ducts, corresponding to natural skin openings (NSOs). The fraction of NSOs with hyperreflective content increased significantly after GMP application compared to baseline (50-75% increase, P = 8.88 × 10-16 ). Similarly, in OCT images, GMPs appeared as hyperreflective columns inside hair follicles and were not detected in surrounding skin. GMPs reached a maximum depth of 920 μm (median 300 μm). After laser exposure, RCM and histology revealed selective perifollicular tissue changes around NSOs.
CONCLUSIONS: Optical imaging visualizes GMP delivery and thermal tissue response following laser exposure and enables bedside monitoring of transfollicular microparticle delivery. Lasers Surg. Med. 51:430-438, 2019. © 2019 Wiley Periodicals, Inc.
OBJECTIVE: To qualitatively and quantitatively describe GMP delivery in vivo and visualize laser-mediated thermal effects of GMPs in facial skin of acne patients and healthy participants, using reflectance confocal microscopy (RCM) and optical coherence tomography (OCT).
METHODS: Patients with facial acne (n = 14), and healthy participants (n = 7) were included. RCM and OCT images were acquired at baseline, after GMP application, and after diode laser exposure. All images were evaluated qualitatively and quantitatively with regards to GMP delivery in skin layers and morphological thermal effects. Lastly, skin biopsies were obtained to compare RCM and OCT findings to histology.
RESULTS: GMPs were delivered equally in healthy participants and acne patients, and in lesional and non-lesional acne skin. In RCM images, GMPs appeared as hyperreflective aggregates inside hair follicles and eccrine ducts, corresponding to natural skin openings (NSOs). The fraction of NSOs with hyperreflective content increased significantly after GMP application compared to baseline (50-75% increase, P = 8.88 × 10-16 ). Similarly, in OCT images, GMPs appeared as hyperreflective columns inside hair follicles and were not detected in surrounding skin. GMPs reached a maximum depth of 920 μm (median 300 μm). After laser exposure, RCM and histology revealed selective perifollicular tissue changes around NSOs.
CONCLUSIONS: Optical imaging visualizes GMP delivery and thermal tissue response following laser exposure and enables bedside monitoring of transfollicular microparticle delivery. Lasers Surg. Med. 51:430-438, 2019. © 2019 Wiley Periodicals, Inc.
摘要：
背景：用于选择性光热解的金微粒（GMPs）的局部应用是最近FDA批准的寻常痤疮疗法。目前的证据表明，光学成像具有非侵入性可视化GMPs并描述光热组织效应的潜力。
目的：定性和定量描述体内GMP递送，并观察痤疮患者和健康参与者面部皮肤中GMPs的激光介导的热效应，使用反射共聚焦显微镜（RCM）和光学相干断层扫描（OCT）。
方法：面部痤疮患者（n=14），包括健康参与者（n=7）。在基线时采集RCM和OCT图像，GMP申请后，和二极管激光曝光后。关于皮肤层中的GMP递送和形态学热效应,对所有图像进行定性和定量评估。最后,我们进行了皮肤活检,以将RCM和OCT的发现与组织学进行比较.
结果：在健康参与者和痤疮患者中，在皮损和非皮损痤疮皮肤中。在RCM图像中，GMPs表现为毛囊和内分泌管内的高反射聚集体，对应于自然皮肤开口(NSO)。与基线相比，GMP应用后具有超反射含量的NSO分数显着增加（增加50-75％，P=8.88×10-16)。同样，在OCT图像中，GMPs在毛囊内表现为高反射柱，在周围皮肤中未检测到。GMPs达到920μm的最大深度(中值300μm)。激光照射后，RCM和组织学显示NSO周围的选择性卵泡周组织变化。
结论：光学成像可使激光照射后的GMP递送和热组织反应可视化，并可在床边监测经卵泡微粒递送。激光器Surg.Med.51:430–438,2019。©2019Wiley期刊，Inc.
目的：定性和定量描述体内GMP递送，并观察痤疮患者和健康参与者面部皮肤中GMPs的激光介导的热效应，使用反射共聚焦显微镜（RCM）和光学相干断层扫描（OCT）。
方法：面部痤疮患者（n=14），包括健康参与者（n=7）。在基线时采集RCM和OCT图像，GMP申请后，和二极管激光曝光后。关于皮肤层中的GMP递送和形态学热效应,对所有图像进行定性和定量评估。最后,我们进行了皮肤活检,以将RCM和OCT的发现与组织学进行比较.
结果：在健康参与者和痤疮患者中，在皮损和非皮损痤疮皮肤中。在RCM图像中，GMPs表现为毛囊和内分泌管内的高反射聚集体，对应于自然皮肤开口(NSO)。与基线相比，GMP应用后具有超反射含量的NSO分数显着增加（增加50-75％，P=8.88×10-16)。同样，在OCT图像中，GMPs在毛囊内表现为高反射柱，在周围皮肤中未检测到。GMPs达到920μm的最大深度(中值300μm)。激光照射后，RCM和组织学显示NSO周围的选择性卵泡周组织变化。
结论：光学成像可使激光照射后的GMP递送和热组织反应可视化，并可在床边监测经卵泡微粒递送。激光器Surg.Med.51:430–438,2019。©2019Wiley期刊，Inc.
