Applications and Future Directions for Optical Coherence Tomography in Dermatology

B. Wan; C. Ganier; X. Du-Harpur; N. Harun; F.M. Watt; R. Patalay; M.D. Lynch


The British Journal of Dermatology. 2021;184(6):1014-1022. 

In This Article

Other Applications of Optical Coherence Tomography Imaging in Dermatology

OCT has additionally been evaluated for a variety of other dermatological indications. In general, while several of these areas show promise, studies are at a relatively early stage and lack detailed quantification of sensitivity and specificity.

OCT studies of skin ageing and photodamage have identified surface irregularity and thickening of the stratum corneum.[75–77] Another area of investigation is scars, which can have significant functional, cosmetic and psychological consequences. Existing scoring systems for the quantification of scarring have a large subjective component,[78] making it challenging to evaluate robustly the efficacy of novel therapeutic modalities. In view of this, there have been efforts to develop OCT-based metrics in scar assessment, for example by measuring the depth and vascularity.[79–81]

OCT has been evaluated for the diagnosis of Malassezia folliculitis. OCT revealed characteristic morphological features of Malassezia pustules; however, Malassezia fungal bodies were not discernible by OCT.[82] OCT can also be used to visualize the nail plate, nailbed and nail matrix[83] and has been employed for the diagnosis of onychomycosis.[84,85]

OCT and angiographic OCT can also provide objective metrics for the assessment of chronic wounds including burns,[86,87] and ulcers resulting from the genetic condition epidermolysis bullosa, where there is a particular concern of SCC formation. Here, OCT has been shown to aid in wound assessment and in reducing requirements for skin biopsy.[88] For bullous dermatoses, such as bullous pemphigoid and pemphigus,[89] OCT associated with RCM can aid with diagnosis and the identification of appropriate biopsy sites.[90] A case report also described the capacity of OCT imaging to reveal in vivo and real-time bullae in mucous membrane pemphigoid.[91]