Optical Coherence Tomography Imaging in Inflammatory Dermatoses
OCT holds considerable promise for the diagnosis and monitoring of inflammatory skin diseases as these are frequently associated with abnormalities of the cutaneous vasculature, and pathology is typically localized to the upper region of the skin. An early study of OCT in inflammatory dermatology evaluated OCT imaging in contact dermatitis and psoriasis. OCT of psoriasis reveals characteristic features, including hyperkeratosis, acanthosis and dilated capillary loops.[64,65] Angiographic OCT imaging of psoriasis reveals 'spikes', which correspond to dilated capillary loops located in the papillary dermis. Angiographic OCT has also been used to evaluate abnormalities of the vasculature in nail psoriasis. Angiographic OCT in particular has the potential for monitoring of treatment efficacy and disease activity. For example, OCT has been used to monitor the response of patients with severe eczema to dupilumab and (in a single case report) the response of patients with psoriasis to secukinumab.
Other inflammatory dermatoses investigated with angiographic OCT include acne, rosacea (where the superficial blood vessels are dilated),[70,71] dermatomyositis and scleroderma (in which the dermis exhibits increased density with loss of cutaneous appendages). Angiographic OCT has also been used to evaluate scalp seborrhoeic dermatitis, psoriasis and contact dermatitis, and in an effort to differentiate irritant and allergic contact dermatitis.
The British Journal of Dermatology. 2021;184(6):1014-1022. © 2021 Blackwell Publishing