背景:无创皮肤检查近年来发展迅速,多光子显微镜(MPM)和反射共聚焦显微镜(RCM)用于以高分辨率对体内皮肤进行成像。这项研究的目的是比较两种技术之间的成像清晰度,并测量不同身体部位的表皮厚度。我们还使用非侵入性工具测量了皮肤老化的程度。
方法:在三个不同的身体部位对56名志愿者进行了评估和测量,包括脸颊,掌侧前臂,和回来。我们使用RCM和MPM来评估每个皮肤层的清晰度,包括角质层,粒状地层,土生层,真皮-表皮交界处,和真皮。我们测量了不同年龄和性别的个体在三个身体部位的表皮厚度(ET)。我们通过二次谐波对真皮自发荧光老化指数(SAAID)评估皮肤老化,采用多元线性回归分析SAAID的影响因素。
结果:MPM在观察颗粒层方面具有优势,胶原纤维,和弹性纤维(p<0.001),但RCM在真皮-表皮连接层提供了更好的观察(p<0.001)。在RCM和MPM检测中,脸颊区域的表皮比前臂和背部的掌侧厚。MPM测得的平均ET低于RCM。ET在三个身体部位之间存在差异,差异有统计学意义(p<0.05)。在40岁以上的个体中,ET在几乎所有部位均显着降低(p<0.05)。SAAID随着年龄的增长而下降,在女性中更快。脸颊的SAAID评分低于其他身体部位。
结论:MPM和RCM提供了非侵入性的皮肤成像方法,每种方法都有自己的优势。表皮厚度和SAAID与年龄相关,性别,和不同的身体部位。MPM还可以评估皮肤老化的程度,可指导上述部位不同年龄、性别患者的临床治疗。
BACKGROUND: Noninvasive skin examination evolved rapidly in recent years, with multiphoton microscopy (MPM) and reflectance confocal microscopy (RCM) being used to image in-vivo skin at high resolution. The aim of this study is to compare the imaging clarity between the two techniques and measure the thickness of the epidermis in different body sites. We also measured the degree of skin aging with noninvasive tools.
METHODS: Fifty-six volunteers were evaluated and measured at three different body sites, including the cheek, volar forearm, and back. We used RCM and MPM to evaluate the clarity of each skin layer, including stratum corneum, stratum granulosum, stratum spinosum, dermo-epidermal junction, and dermis. We measured epidermal thickness (ET) at the three body sites in individuals of different ages and genders. We assessed skin aging by the second harmonic to autofluorescence aging index of dermis (SAAID), and multiple linear regression was used to analyze the factors affecting SAAID.
RESULTS: MPM had advantages in observation of stratum granulosum, collagen fiber, and elastic fiber (p < 0.001), but RCM provided better observation in dermo-epidermal junction layer (p < 0.001). The epidermis was thicker in the cheek area than the volar forearm and back in both RCM and MPM detection, and the average ET measured by MPM was lower than RCM. ET varied among the three body sites with significant differences (p < 0.05). ET was significantly lower at almost all sites in individuals above 40y (p < 0.05). SAAID decreased with age, and more rapidly in women. Cheeks have lower SAAID scores than other body sites.
CONCLUSIONS: MPM and RCM provide noninvasive methods for imaging skin and each method has its own advantages. Epidermal thickness and SAAID correlated with age, gender, and different body sites. MPM could also assess the degree of skin aging, which could guide the clinical treatment of patients with diffferent ages and genders in the above body sites.