Fluorescence--remission sensoring of skin tumours: preliminary results.
OBJECTIVE
Nonmelanoma skin cancer (NMSC) is one of the most common malignancies in men. Objective evaluation by digital dermoscopy, as for pigmented lesions, does not provide sufficient data to discriminate between benign and malignant lesions. Therefore, other techniques have to be developed.


METHODS
Hospitalized patients of an academic teaching hospital were evaluated.


METHODS
Because the simultaneous measurement of fluorescence and remission of skin is impossible, a principle of subsequent measurement of remission and fluorescence had been developed by our group. This was combined with dermoscopic imaging. VIS-NIR remission spectroscopy was performed using the laboratory device TIDAS. Fluorescence spectroscopy was realized using a SKINSKAN. Fluorescence emission was detected by a highly sensitive PMT-detector. Based on this evaluation, we developed an optimized measuring device (FRIS, fluorescence-remission-imaging sensor) combining sensors for fluorescence, remission and digital imaging with a white light ring illumination, a drilled mirror and fibre optics. FRIS consists of an industrial personal computer with a touch screen combining three UV-VIS spectrometer modules and a white light source for remission measurements and referencing. Furthermore, included are a CCD coloured camera module and an LED white light ring-illumination. Fluorescence emission is realized by a UV-LED with a peak wavelength of 370 nm. System control uses Window frames and a specifically developed software Skinrem3.exe . Using this technology, we performed a pilot study in 19 patients with 30 NMSC-suspicious lesions including: actinic keratosis (n=10), basal cell carcinoma (BCC; n=16) and squamous cell carcinoma (SCC; n=4 with two in situ carcinomas).


RESULTS
Reproducibility measured or FRIS by relative standard deviation of repeated spectroscopic measurements was <0.1% for remission and 2% for fluorescence. The technology was able to generate typical pattern of remission-corrected fluorescence data. The fluorescence differences at 430 nm allow a differentiation between actinic keratoses and BCC. A decrease of the corrected lesional fluorescence >2 AU indicates BCC. To substantiate the diagnostic potency of this technology, further studies are needed.


CONCLUSIONS
A combination of fluorescence and remission readings of skin provides objective data in NMSC. We developed the FRIS equipment that allows a reproducible measurement and easy handling.
Wollina
Uwe
U
Department of Dermatology and Allergology, Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Friedrichstrasse, Dresden, Germany. wollina-uw@khdf.de
Nelskamp
Cornelia
C
Scheibe
Armin
A
Fassler
Dieter
D
Schmidt
Wolf-Dieter
WD
D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology*; D003880:Dermatology / Q000295:instrumentation / Q000379:methods; D046169:Dermoscopy; D003937:Diagnosis, Differential; D005260:Female; D005453:Fluorescence; D006801:Humans; D007642:Keratosis / Q000473:pathology*; D008297:Male; D010865:Pilot Projects; D015203:Reproducibility of Results; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology*; D019265:Spectroscopy, Near-Infrared / Q000295:instrumentation / Q000379:methods* / Q000592:standards