title: Objective and subjective treatment evaluation of scars using optical coherence tomography, sonography, photography, and standardised questionnaires.
abstract: BACKGROUND
  Currently, different types of treatments for pathological scars are available, however, to date, there is no established method of measurement to objectively assess therapeutic outcome. Treatment success is usually evaluated clinically by the physician and patient. Non-invasive imaging techniques, such as HD-OCT (high-definition optical coherence tomography), may represent a valuable diagnostic tool to objectively measure therapeutic outcome.
  
  
  OBJECTIVE
  To compare HD-OCT with ultrasound and subjective evaluation tools, such as questionnaires.
  
  
  METHODS
  In total, eight patients with pathological scars were treated in this pilot study with cryotherapy and intralesional steroid injections, and evaluated pre- and post-treatment using clinical examination, photography, sonography, and HD-OCT. The analysis of objective and subjective measuring methods was used to draw direct comparisons.
  
  
  RESULTS
  HD-OCT revealed reduced epidermal and dermal thickness of the scar after four treatments with triamcinolone acetonide and cryotherapy. Based on sonography, a total reduction in scar height and reduction in scar depth was demonstrated. Both methods correlated well with the injected amount of triamcinolone acetonide. In addition, a positive correlation between well-established subjective and objective evaluation methods was found.
  
  
  CONCLUSIONS
  We demonstrate that HD-OCT may be used as an objective diagnostic instrument to evaluate skin thickness under therapy for pathological scars, and serves as a valuable adjunctive device in combination with ultrasound and subjective evaluation tools. This provides additional information for the therapist concerning the quality and success of the applied treatment.
authors.affiliation: Department of Dermatology and Allergology, University Hospital of Munich (LMU), Munich.
authors.forename: Markus
authors.initials: M
authors.lastname: Reinholz
authors.affiliation: Department of Dermatology and Allergology, University Hospital of Munich (LMU), Munich.
authors.forename: Hannah
authors.initials: H
authors.lastname: Schwaiger
authors.affiliation: Department of Dermatology and Allergology, University Hospital of Munich (LMU), Munich.
authors.forename: Julian
authors.initials: J
authors.lastname: Poetschke
authors.affiliation: Department of Dermatology and Allergy, Ruprecht-Karl University, Heidelberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Epple
authors.affiliation: Department of Dermatology and Allergology, University Hospital of Munich (LMU), Munich.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.affiliation: Department of Dermatology and Allergology, University Hospital of Munich (LMU), Munich.
authors.forename: Tanja
authors.initials: T
authors.lastname: Von Braunmühl
authors.affiliation: Department of Dermatology and Allergology, University Hospital of Munich (LMU), Munich.
authors.forename: Gerd G
authors.initials: GG
authors.lastname: Gauglitz
mesh_terms: D000328:Adult; D000368:Aged; D017439:Cicatrix, Hypertrophic / Q000000981:diagnostic imaging* / Q000628:therapy; D017679:Cryotherapy; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007627:Keloid / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010781:Photography; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D014222:Triamcinolone Acetonide
keywords: hypertrophic scar; keloid; non-invasive; objective measuring methods; optical coherence tomography