背景:光声显微镜有望作为观察皮内结构的非侵入性和三维(3D)方法具有临床应用。
目的:研究配备两种类型的脉冲激光的光声显微镜的适用性,该激光可以同时识别血红蛋白和黑色素。
方法:16个皮肤损伤,包括红斑,色素性病变,白癜风和紫癜,进行分析,以可视化黑色素颗粒分布和真皮血管的3D结构。进一步分析了13例皮肤结节性多动脉炎(cPN)中的livedoracemosa,以详细显示真皮血管的3D结构。还通过CD34免疫染色分析了从cPN的硬化红斑中获得的活检标本中的血管结构。
结果:白癜风患者血红蛋白识别信号清楚地显示真皮血管的3D结构,黑色素识别信号持续降低。在Livedoracemosa,血红蛋白识别信号显示,在较深层的网状结构相对较厚和较大,向上层变得更致密和更细。数值分析显示,皮损较深区域的真皮血管数量比正常皮肤高1.29倍(p<0.05)。嫩性硬结红斑的CD34免疫组化分析显示,与正常皮肤相比,88.9%(8/9)的病例中真皮血管数量增加,提示cPN中发生了血管网络重塑。
结论:光声系统在无创检测二维组织病理学标本难以识别的真皮血管结构方面具有优势,在各种皮肤病中值得评估。
BACKGROUND: Photoacoustic microscopy is expected to have clinical applications as a noninvasive and three-dimensional (3D) method of observing intradermal structures.
OBJECTIVE: Investigate the applicability of a photoacoustic microscope equipped with two types of pulsed lasers that can simultaneously recognize hemoglobin and melanin.
METHODS: 16 skin lesions including erythema, pigmented lesions, vitiligo and purpura, were analyzed to visualize 3D structure of melanin granule distribution and dermal blood vessels. 13 cases of livedo racemosa in cutaneous polyarteritis nodosa (cPN) were further analyzed to visualize the 3D structure of dermal blood vessels in detail. Vascular structure was also analyzed in the biopsy specimens obtained from tender indurated erythema of cPN by CD34 immunostaining.
RESULTS: Hemoglobin-recognition signal clearly visualized the 3D structure of dermal blood vessels and melanin-recognition signal was consistently reduced in vitiligo. In livedo racemosa, the hemoglobin-recognition signal revealed a relatively thick and large reticular structure in the deeper layers that became denser and finer toward the upper layers. The numerical analysis revealed that the number of dermal blood vessels was 1.29-fold higher (p<0.05) in the deeper region of the lesion than that of normal skin. The CD34 immunohistochemical analysis in tender indurated erythema revealed an increased number of dermal vessels compared with normal skin in 88.9% (8/9) of the cases, suggesting that vascular network remodeling had occurred in cPN.
CONCLUSIONS: The photoacoustic system has an advantage in noninvasively detecting dermal blood vessel structures that are difficult to recognize by two-dimensional histopathology specimen examination and is worth evaluating in various skin diseases.