Dermoscopy, Reflectance Confocal Microscopy and Optical Coherence Tomography Features of Acne: A Systematic Review
Abstract
:1. Introduction
2. Methods
2.1. Study Selection Criteria
2.2. Data Search
2.3. Study Selection and Data Collection
2.4. Study Outcomes
3. Results
Study Selection
4. Dermoscopy in Acne Lesions
5. Rcm in Acne Lesions and Perilesional Skin
6. Oct in Acne Lesions
7. Acne Pathophysiology
- (1)
- Initially, acne skin is characterized by an increased number of small bright follicles (microcomedos).
- (2)
- Subsequently, several large bright follicles appear in the area of interest, associated with increased hyperkeratinization of the infundibula, leading to its occlusion (comedos).
- (3)
- Abruptly, several inflammatory phenomena occur with the appearance of papules, pustules, or nodular lesions with increased vessel density, exocytosis, and organized inflammatory infiltrate and an increase of adjacent small bright follicles.
- (4)
- Finally, resolution of the inflammatory lesion is characterized by the absence of inflammatory phenomena and the persistence of an increased number of small and large bright follicles associated with dilated sebaceous gland morphology.
8. Noninvasive Acne Therapy Monitoring
9. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Elementary Acne Lesion Features | Dermoscopy Features | RCM Features | OCT Features | Histopathology Features |
---|---|---|---|---|
Comedos | Dilated pilosebaceous units filled with a white-yellow circle or a brown plug | Enlarged infundibula with a hyperkeratotic bright border | Enlarged infundibula with hyperkeratinized borders and a variable darker appearance depending on the amount of keratin. | A comedo is an altered pilo-sebaceous unit characterized by the presence of hyperkeratinization at the infundibulum and the istmus. The histopathologic appearance of comedos is characterized by the presence of a cyst-like cavity with a keratinous mass, colonized by bacteria. |
Papules | Erythematous roundish lesions | Poorly defined lesions with intact or excoriated epidermis and an abundant inflammatory infiltrate in the epidermis or in the dermis. | Dome-shaped lesions with an either intact or thin and uneven epidermal surface and abundant inflammatory phenomena. | Papules are dome-shaped skin lesions characterized by the accumulation of inflammatory cells in dermis in a circumscribed area around one or more pilosebaceous units |
Pustules | Inflammatory lesions centered by a white-yellowish area | Inflammatory lesions characterized by the accumulation of an organized inflammatory infiltrate and increased vascularity | Dome- shaped lesions characterized by abundant inflammatory phenomena associated to the presence of purulent aggregates inside the pustular cavity. | Pustules are dome-shaped skin lesions characterized by the accumulation of neutrophils within comedones, usually leading to the rupture of the original cystic cavity in the dermis. |
Author | Number of Patients | Study Design | Acne Severity Grade | Technique | Number of Acquired Skin Areas | Aim of the Study | Type of Treatment |
---|---|---|---|---|---|---|---|
Manfredini 2015 [5] | 35 | Observational study | Absent to moderate | RCM | 55 | Acne characterization | n.s. |
Manfredini 2019 [6] | 10 | Observational pilot study | Mild to moderate | RCM and OCT | 70 RCM and 70 OCT | Acne characterization | n.s. |
Fuchs 2018 [7] | 21 | Explorative | Absent to moderate | RCM and OCT | 108 RCM and 54 OCT | Acne characterization | n.s. |
Guenot 2018 [8] | 42 | Prospective | n.s. | RCM | 42 | Acne characterization in adult women | n.s. |
Manfredini 2017 [9] | 19 | Observational study | Mild to moderate | RCM | 76 | Treatment monitoring | Hydroypinacolone retinoate/BIOPEP |
Garofalo 2019 [10] | 20 | Pilot study | Mild | RCM | 60 | Treatment monitoring | Benzoylperoxide 4%, retinol 0.5%, mandelic acid 1%, and lactobionic acid 1% |
Fuchs 2021 [11] | 15 | Prospective study | Mild to moderate | RCM and OCT | 60 RCM and 60 OCT | Treatment monitoring | Adapalen-benzoyl peroxide |
Manfredini 2017 [12] | 31 | Prospective | Mild to moderate | OCT | 132 | Treatment monitoring | Oral antibiotic tratment |
Capitanio 2014 [13] | 28 | Prospective | Absent to mild | RCM | 8 | Treatment monitoring | Mixed RetinSphere- vitamin E formulation |
Fuchs 2019 [14] | 12 | n.s. | Absent to moderate | RCM and OCT | 109 RCM and 120 OCT | Treatment monitoring | Gold microparticles |
Rossi 2018 [15] | 2 | n.s. | n.s. | RCM | 4 | Treatment monitoring | Plasma exeresis |
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Alma, A.; Sticchi, A.; Chello, C.; Guida, S.; Farnetani, F.; Chester, J.; Bettoli, V.; Pellacani, G.; Manfredini, M. Dermoscopy, Reflectance Confocal Microscopy and Optical Coherence Tomography Features of Acne: A Systematic Review. J. Clin. Med. 2022, 11, 1783. https://doi.org/10.3390/jcm11071783
Alma A, Sticchi A, Chello C, Guida S, Farnetani F, Chester J, Bettoli V, Pellacani G, Manfredini M. Dermoscopy, Reflectance Confocal Microscopy and Optical Coherence Tomography Features of Acne: A Systematic Review. Journal of Clinical Medicine. 2022; 11(7):1783. https://doi.org/10.3390/jcm11071783
Chicago/Turabian StyleAlma, Antonio, Alberto Sticchi, Camilla Chello, Stefania Guida, Francesca Farnetani, Johanna Chester, Vincenzo Bettoli, Giovanni Pellacani, and Marco Manfredini. 2022. "Dermoscopy, Reflectance Confocal Microscopy and Optical Coherence Tomography Features of Acne: A Systematic Review" Journal of Clinical Medicine 11, no. 7: 1783. https://doi.org/10.3390/jcm11071783
APA StyleAlma, A., Sticchi, A., Chello, C., Guida, S., Farnetani, F., Chester, J., Bettoli, V., Pellacani, G., & Manfredini, M. (2022). Dermoscopy, Reflectance Confocal Microscopy and Optical Coherence Tomography Features of Acne: A Systematic Review. Journal of Clinical Medicine, 11(7), 1783. https://doi.org/10.3390/jcm11071783