Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

Background: Actinic keratoses (AK) represent cutaneous carcinoma in situ and have previously been evaluated by reflectance confocal microscopy (RCM). Treatment of AK with imiquimod (IMIQ) 5% cream has been shown to ‘highlight’ subclinical lesions. Objective: The aim of this study was to test the app...

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Published inDermatology (Basel) Vol. 220; no. 1; pp. 15 - 24
Main Authors Ulrich, M., Krueger-Corcoran, D., Roewert-Huber, J., Sterry, W., Stockfleth, E., Astner, S.
Format Journal Article
LanguageEnglish
Published Basel, Switzerland Karger 01.01.2010
S. Karger AG
Subjects
Aged
Aminoquinolines - therapeutic use
Antineoplastic Agents - therapeutic use
Biological and medical sciences
Carcinoma in Situ - drug therapy
Carcinoma in Situ - pathology
Dermatology
Drug Monitoring - methods
Humans
Keratosis, Actinic - drug therapy
Keratosis, Actinic - pathology
Medical diagnosis
Medical sciences
Microscopy
Microscopy, Confocal - methods
Middle Aged
Original Paper
Skin diseases
Treatment Outcome
Noninvasive diagnosis
Confocal microscopy
Imiquimod
Actinic keratoses
Monitoring
Dermatology
Asymptomatic
Immunomodulator
Treatment
Surveillance
Antiviral
Diagnosis
Keratosis
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Summary:Background: Actinic keratoses (AK) represent cutaneous carcinoma in situ and have previously been evaluated by reflectance confocal microscopy (RCM). Treatment of AK with imiquimod (IMIQ) 5% cream has been shown to ‘highlight’ subclinical lesions. Objective: The aim of this study was to test the applicability of RCM for noninvasive monitoring of actinic field cancerization and detection of subclinical AK. Subjects and Methods: AK and surrounding skin sites with no apparent AK of 11 volunteers were selected for imaging and subsequently classified as ‘clinical’ and ‘subclinical’ AK. IMIQ was used 3 times weekly for 4 weeks. Results: RCM was able to detect morphologic features of AK in both clinical and subclinical AK; features were more pronounced in clinical lesions. The immunomodulatory response induced by IMIQ was visualized by RCM. Conclusion: Our findings indicate that RCM allows noninvasive monitoring of treatment response in vivo and permits early detection of subclinical AK, thus substantiating the incentive for therapy.
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ISSN:1018-8665
1421-9832
1421-9832
DOI:10.1159/000254893