Optical coherence tomography of the human skin,☆☆,,★★

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Abstract

Background: Optical coherence tomography (OCT) is a new diagnostic method for tissue characterization.

Objective: We investigated normal and pathologic structures in human skin in several locations to evaluate the potential application of this technique to dermatology.

Methods: Based on the principle of low-coherence interferometry, cross-sectional images of the human skin can be obtained in vivo with a high spatial resolution of about 15 μm. Within a penetration depth of 0.5 to 1.5 mm, structures of the stratum corneum, the living epidermis, and the papillary dermis can be distinguished.

Results: Different layers could be detected that were differentiated by induction of experimental blisters and by comparison with corresponding histologic sections. Furthermore, OCT images of several skin diseases and tumors were obtained.

Conclusion: OCT is a promising new imaging method for visualization of morphologic changes of superficial layers of the human skin. It may be useful for noninvasive diagnosis of bullous skin diseases, skin tumors, and in vivo investigation of pharmacologic effects. (J Am Acad Dermatol 1997;37:958-63.)

Section snippets

Technique

The OCT system is based on the principle of Michelson interferometry using short coherence length light. Infrared light from a 830 nm superluminescence diode is coupled into an optical fiber interferometer. The optical path length distribution of the sample beam measured by the interference modulation of the axial OCT scan can be interpreted as the depth resolved reflection signal of the sample. Interference occurs only when the propagation distance of both beams match within the coherence

RESULTS

The correlation between OCT images and histology of normal skin can be seen in Fig. 1.

. Healthy skin of fingertip. A, OCT and (B) corresponding histology. The superficial layer is thick stratum corneum. Stratum lucidum is less dense. The signal dense deeper layer can be assigned to epidermis. Note sweat gland duct. OCT image: 1 × 1.5 mm. (B, Original magnification × 100.)

The OCT cross sections showed differences depending on the location. On the palm, especially on the fingers, a thick stratum

DISCUSSION

Superficial human skin can be visualized with high-resolution OCT. Different layers of healthy skin can be distinguished as well as bullous changes and skin tumors. In conjunction with histologic examination we were able to assign the structures seen in OCT to microscopic morphology. In different experimentally induced bullous changes of the skin we were able to distinguish between the layers seen in OCT images.

The axial resolution of 15 μm allowed detection of cell aggregates and layers in

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From the Department of Dermatology, Medical University of Lübeck,a and the Medical Laser Center, Lübeck.b

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Supported in part by the German Ministry of Science and Research (BMBF), FK No. 13N6302.

Reprint requests: Julia Welzel, MD, Department of Dermatology, Medical University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany.

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