Background:Pathological scars are a disorder that can lead to various cosmetic,psychological,and functional problems,and no effective assessment methods are currently available.Assessment and treatment of pathological scars are based on cutaneous manifestations.A two-photon microscope(TPM)with the potential for real-time non-invasive assessment may help determine the under-surface pathophysiological conditions in vivo.This study used a portable handheld TPM to image epidermal cells and dermal collagen structures in pathological scars and normal skin in vivo to evaluate the effectiveness of treatment in scar patients.Methods:Fifteen patients with pathological scars and three healthy controls were recruited.Imaging was performed using a portable handheld TPM.Five indexes were extracted from two dimensional(2D)and three dimensional(3D)perspectives,including collagen depth,dermo-epidermal junction(DEJ)contour ratio,thickness,orientation,and occupation(proportion of collagen fibers in the field of view)of collagen.Two depth-dependent indexes were computed through the 3D second harmonic generation image and three morphology-related indexes from the 2D images.We assessed index differences between scar and normal skin and changes before and after treatment.Results:Pathological scars and normal skin differed markedly regarding the epidermal morphological structure and the spectral characteristics of collagen fibers.Five indexes were employed to distinguish between normal skin and scar tissue.Statistically significant differences were found in average depth(t=9.917,P<0.001),thickness(t=4.037,P<0.001),occupation(t=2.169,P<0.050),orientation of collagen(t=3.669,P<0.001),and the DEJ contour ratio(t=5.105,P<0.001).Conclusions:Use of portable handheld TPM can distinguish collagen from skin tissues;thus,it is more suitable for scar imaging than reflectance confocal microscopy.Thus,a TPM may be an auxiliary tool for scar treatment selection and assessing treatment efficacy.
Yang Han;Yuxuan Sun;Feili Yang;Qingwu Liu;Wenmin Fei;Wenzhuo Qiu;Junjie Wang;Linshuang Li;Xuejun Zhang;Aimin Wang;Yong Cui;
Graduate School,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100730,China Department of Dermatology,China-Japan Friendship Hospital,Beijing 100029,ChinaCollege of Engineering,Peking University,Beijing 100871,ChinaSchool of Chemical Biology and Biotechnology,State Key Laboratory of Chemical Oncogenomics,Peking University Shenzhen Graduate School,Shenzhen,Guangdong 518055,ChinaDepartment of Dermatology,China-Japan Friendship Hospital,Beijing 100029,ChinaDepartment of Dermatology,The First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330006,ChinaAcademy for Advanced Interdisciplinary Studies,Peking University,Beijing 100871,ChinaCollege of Future Technology,Peking University,Beijing 100871,ChinaBeijing Transcend Vivoscope Biotech,Beijing 100085,ChinaDepartment of Dermatology,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230001,China Institute of Dermatology,Anhui Medical University,Hefei,Anhui 230001,ChinaSchool of Electronics,Peking University,Beijing 100871,China
临床医学
Scars;Two-photon microscope;Two-photon excitation fluorescence;Second harmonic generation microscopy
《Chinese Medical Journal》 2024 (003)
P.329-337 / 9
supported by grants from Beijing Municipal Science and Technology Commission Medicine Collaborative Science and Technology Innovation Research Project(No.Z191100007719001);To Establish a Database and Study the Imaging Features of Common Skin Diseases based on Two-photon Imaging Technology(No.SK2021090379-1)
10.1097/CM9.0000000000002715
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