title: Fluorescent fibre-optic confocal imaging of lesional and non-lesional psoriatic skin compared with normal skin in vivo.
abstract: OBJECTIVE
  Fibre-optic confocal imaging (FOCI) allows non-invasive visualization of live skin in vivo. A contrast agent, a fluorophore, is injected in the dermis. FOCI images are optical sections from a horizontal (en face) view. The aim was to study epidermis and the cellular structure of keratinocytes of psoriatic plaques and adjacent non-lesional with healthy skin as a reference.
  
  
  METHODS
  Twelve patients with stable plaque psoriasis were studied and compared with a control group of eight healthy individuals. Fluorescein sodium was used as fluorophore. A hand held fibre-optic laser scanner (Stratum(®); Optiscan Pty., Melbourne, Australia) was used. The study included morphometric analyses.
  
  
  RESULTS
  The confocal in vivo images demonstrated characteristic features of epidermis and keratinocytes in lesional and non-lesional skin vs. healthy skin. Morphometry based on FOCI demonstrated an approximately 30% increased width of keratinocytes of psoriatic skin vs. healthy control, and the number of keratinocytes per viewing field was reduced. FOCI allowed non-invasive visualization of cell nuclei and parakeratosis of psoriatic epidermis. The horizontal width of dermal papillae of psoriatic skin was increased by approximately 50% as compared with healthy skin, and the flow of erythrocytes in the papillar vessels could be observed in real-time.
  
  
  CONCLUSIONS
  FOCI can directly visualize essential epidermal structures of plaque psoriasis in vivo, in real-time and with cellular resolution without the need of taking biopsies and thus without disturbing the natural state of the skin. FOCI is a versatile future tool for non-invasive microscopic diagnosis and therapy follow-up of psoriasis.
authors: Dermatology and Venerology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden. christian.suihko@liu.se
authors: Christian
authors: C
authors: Suihko
authors: Jørgen
authors: J
authors: Serup
mesh_terms: D000328:Adult; D000368:Aged; D046169:Dermoscopy / Q000295:instrumentation*; D019544:Equipment Failure Analysis; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation*; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000295:instrumentation*; D008856:Microscopy, Fluorescence / Q000295:instrumentation*; D008875:Middle Aged; D011565:Psoriasis / Q000473:pathology*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology*