In Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy

Reflectance confocal microscopy (RCM) presents a non-invasive method to image actinic keratosis (AK) at a cellular level. However, RCM criteria for AK response monitoring vary across studies and a universal, standardized approach is lacking. We aimed to identify reliable AK response criteria and to...

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Autores principales:	Clara Curiel-Lewandrowski, Caitlyn N. Myrdal, Kathylynn Saboda, Chengcheng Hu, Edith Arzberger, Giovanni Pellacani, Franz Josef Legat, Martina Ulrich, Petra Hochfellner, Margaret C. Oliviero, Paola Pasquali, Melissa Gill, Rainer Hofmann-Wellenhof
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	reflectance confocal microscopy actinic keratosis response monitoring cryotherapy photodynamic therapy RCM Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/5a3decc587444e4096c869afe3b549a5
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spelling	oai:doaj.org-article:5a3decc587444e4096c869afe3b549a52021-11-11T15:33:41ZIn Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy10.3390/cancers132154882072-6694https://doaj.org/article/5a3decc587444e4096c869afe3b549a52021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5488https://doaj.org/toc/2072-6694Reflectance confocal microscopy (RCM) presents a non-invasive method to image actinic keratosis (AK) at a cellular level. However, RCM criteria for AK response monitoring vary across studies and a universal, standardized approach is lacking. We aimed to identify reliable AK response criteria and to compare the clinical and RCM evaluation of responses across AK severity grades. Twenty patients were included and randomized to receive either cryotherapy (<i>n</i> = 10) or PDT (<i>n</i> = 10). Clinical assessment and RCM evaluation of 12 criteria were performed in AK lesions and photodamaged skin at baseline, 3 and 6 months. We identified the RCM criteria that reliably characterize AK at baseline and display significant reduction following treatment. Those with the highest baseline odds ratio (OR), good interobserver agreement, and most significant change over time were atypical honeycomb pattern (OR: 12.7, CI: 5.7–28.1), hyperkeratosis (OR: 13.6, CI: 5.3–34.9), stratum corneum disruption (OR: 7.8, CI: 3.5–17.3), and disarranged epidermal pattern (OR: 6.5, CI: 2.9–14.8). Clinical evaluation demonstrated a significant treatment response without relapse. However, in grade 2 AK, 10/12 RCM parameters increased from 3 to 6 months, which suggested early subclinical recurrence detection by RCM. Incorporating standardized RCM protocols for the assessment of AK may enable a more meaningful comparison across clinical trials, while allowing for the early detection of relapses and evaluation of biological responses to therapy over time.Clara Curiel-LewandrowskiCaitlyn N. MyrdalKathylynn SabodaChengcheng HuEdith ArzbergerGiovanni PellacaniFranz Josef LegatMartina UlrichPetra HochfellnerMargaret C. OlivieroPaola PasqualiMelissa GillRainer Hofmann-WellenhofMDPI AGarticlereflectance confocal microscopyactinic keratosisresponse monitoringcryotherapyphotodynamic therapyRCMNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5488, p 5488 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	reflectance confocal microscopy actinic keratosis response monitoring cryotherapy photodynamic therapy RCM Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	reflectance confocal microscopy actinic keratosis response monitoring cryotherapy photodynamic therapy RCM Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Clara Curiel-Lewandrowski Caitlyn N. Myrdal Kathylynn Saboda Chengcheng Hu Edith Arzberger Giovanni Pellacani Franz Josef Legat Martina Ulrich Petra Hochfellner Margaret C. Oliviero Paola Pasquali Melissa Gill Rainer Hofmann-Wellenhof In Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy
description	Reflectance confocal microscopy (RCM) presents a non-invasive method to image actinic keratosis (AK) at a cellular level. However, RCM criteria for AK response monitoring vary across studies and a universal, standardized approach is lacking. We aimed to identify reliable AK response criteria and to compare the clinical and RCM evaluation of responses across AK severity grades. Twenty patients were included and randomized to receive either cryotherapy (<i>n</i> = 10) or PDT (<i>n</i> = 10). Clinical assessment and RCM evaluation of 12 criteria were performed in AK lesions and photodamaged skin at baseline, 3 and 6 months. We identified the RCM criteria that reliably characterize AK at baseline and display significant reduction following treatment. Those with the highest baseline odds ratio (OR), good interobserver agreement, and most significant change over time were atypical honeycomb pattern (OR: 12.7, CI: 5.7–28.1), hyperkeratosis (OR: 13.6, CI: 5.3–34.9), stratum corneum disruption (OR: 7.8, CI: 3.5–17.3), and disarranged epidermal pattern (OR: 6.5, CI: 2.9–14.8). Clinical evaluation demonstrated a significant treatment response without relapse. However, in grade 2 AK, 10/12 RCM parameters increased from 3 to 6 months, which suggested early subclinical recurrence detection by RCM. Incorporating standardized RCM protocols for the assessment of AK may enable a more meaningful comparison across clinical trials, while allowing for the early detection of relapses and evaluation of biological responses to therapy over time.
format	article
author	Clara Curiel-Lewandrowski Caitlyn N. Myrdal Kathylynn Saboda Chengcheng Hu Edith Arzberger Giovanni Pellacani Franz Josef Legat Martina Ulrich Petra Hochfellner Margaret C. Oliviero Paola Pasquali Melissa Gill Rainer Hofmann-Wellenhof
author_facet	Clara Curiel-Lewandrowski Caitlyn N. Myrdal Kathylynn Saboda Chengcheng Hu Edith Arzberger Giovanni Pellacani Franz Josef Legat Martina Ulrich Petra Hochfellner Margaret C. Oliviero Paola Pasquali Melissa Gill Rainer Hofmann-Wellenhof
author_sort	Clara Curiel-Lewandrowski
title	In Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy
title_short	In Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy
title_full	In Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy
title_fullStr	In Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy
title_full_unstemmed	In Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy
title_sort	in vivo reflectance confocal microscopy as a response monitoring tool for actinic keratoses undergoing cryotherapy and photodynamic therapy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/5a3decc587444e4096c869afe3b549a5
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In Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy

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