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Background Hydradermabrasion, also known as “HydraFacial,” is an exfoliative cosmetic procedure for skin rejuvenation that has gained popularity. Despite its increasing popularity, clinical studies validating its efficacy with non‐invasive assessment of histological changes to the skin, are scarce. In this study, we used Line‐Field Confocal Optical Coherence Tomography (LC‐OCT), an optical imaging device, to non‐invasively visualize microscopic changes to skin anatomy after hydradermabrasion treatment. Materials/Methods Eight volunteers (Fitzpatrick skin types II–V) were recruited for this study. Images, using LC‐OCT (DeepLive, DAMAE medical) were obtained before and after hydradermabrasion and at 2 weeks post‐treatment. A commercially available hydradermabrasion device was utilized to perform the dermabrasion. Results In the epidermis, initially, a decrease in the average thickness of the stratum corneum, from 9.42 to 6.67 µm was visualized in LC‐OCT images after hydradermabrasion. However, at 2 weeks of follow‐up, the average stratum corneum thickness was 9.75 µm, resulting in an overall increase in the average thickness after treatment. Improved homogenization of the stratum corneum and decreased number of undulations in the epidermis post‐treatment were also visualized. In all the subjects, the superficial dermis appeared stretched, which returned to baseline by the 2‐week follow‐up. At the 2‐week follow‐up, there were no visible differences in the quality and quantity of collagen fibers in the dermis. Conclusion In our study, LC‐OCT images of the epidermis and dermis demonstrated microscopic features of skin rejuvenation when treated with hydradermabrasion. Thus, not only highlighting the efficacy of hydradermabrasion but also the potential of LC‐OCT to serve as a tool for visualizing the microscopic effects of cosmetic procedures on skin anatomy.

Background While shaving‐induced erythema is a common inflammatory skin issue, there is a lack of quantitative information on how well a shaving product performs in this regard. In this study, multispectral near‐infrared spectroscopy (NIRS) imaging was used to quantitatively and qualitatively measure the extent of shaving‐induced erythema. The research compares a safety razor and a cartridge razor to evaluate their impact on skin irritation. Materials and methods Fifty‐nine healthy male volunteers without pre‐existing skin conditions were enrolled. Basic demographics were recorded, and participants' faces or necks were imaged before shaving. Shaving was conducted on the right side of the face/neck with the safety razor and on the left side of the face/neck using the 3‐blade cartridge razor. Images were captured immediately after shaving, at 5 and 10 min post‐shaving. Results Tissue oxygen saturation (StO2) measurements demonstrated that the safety razor induced significantly less erythema than the cartridge razor. Immediately after shaving, 40.3% of skin shaved with the safety razor had erythema compared to 57.6% for the cartridge razor. At 5 min post‐shaving, 36.5% of skin shaved with the safety razor had erythema, compared to 53.8% of cartridge razor. Conclusions Multispectral NIRS revealed significant differences in shaving‐induced erythema between safety and cartridge razors. Safety razors demonstrated a lower incidence of erythema, suggesting a potential advantage for individuals prone to skin irritation. This study contributes valuable insights into skin irritation and highlights the potential of multispectral NIRS in dermatology research.

Electrocardiography imaging (ECGi) is a non‐invasive inverse reconstruction procedure which employs body surface potential maps (BSPM) obtained from surface electrode array measurements to improve the spatial resolution and interpretability of conventional electrocardiography (ECG) for the diagnosis of cardiac dysfunction. ECGi currently lacks precision, which has prevented its adoption in clinical setups. The introduction of high‐density electrode arrays could increase ECGi reconstruction accuracy but is not attempted before due to manufacturing and processing limitations. Advances in multiple fields have now enabled the implementation of such arrays which poses questions on optimal array design parameters for ECGi. In this work, a novel conducting polymer electrode manufacturing process on flexible substrates is proposed to achieve high‐density, mm‐sized, conformable, long‐term, and easily attachable electrode arrays for BSPM with parameters optimally selected for ECGi applications. Temporal, spectral, and correlation analysis are performed on a prototype array demonstrating the validity of the chosen parameters and the feasibility of high‐density BSPM, paving the way for ECGi devices fit for clinical application. A high‐density conducting polymer electrode array for body surface potential mapping (BSPM) is proposed, with parameters optimally selected for electrocardiographic imaging (ECGi) applications. Temporal, spectral, and correlation analyses performed on prototype arrays confirm the optimal set of parameters and demonstrate the feasibility of high‐density BSPM, paving the way for ECGi devices fit for clinical application.

Background Inflammatory skin diseases, such as psoriasis, atopic eczema, and contact dermatitis pose diagnostic challenges due to their diverse clinical presentations and the need for rapid and precise diagnostic assessment. Objective While recent studies described non‐invasive imaging devices such as Optical coherence tomography and Line‐field confocal OCT (LC‐OCT) as possible techniques to enable real‐time visualization of pathological features, a standardized analysis and validation has not yet been performed. Methods One hundred forty lesions from patients diagnosed with atopic eczema (57), psoriasis (50), and contact dermatitis (33) were imaged using OCT and LC‐OCT. Statistical analysis was employed to assess the significance of their characteristic morphologic features. Additionally, a decision tree algorithm based on Gini's coefficient calculations was developed to identify key attributes and criteria for accurately classifying the disease groups. Results Descriptive statistics revealed distinct morphologic features in eczema, psoriasis, and contact dermatitis lesions. Multivariate logistic regression demonstrated the significance of these features, providing a robust differentiation between the three inflammatory conditions. The decision tree algorithm further enhanced classification accuracy by identifying optimal attributes for disease discrimination, highlighting specific morphologic criteria as crucial for rapid diagnosis in the clinical setting. Conclusion The combined approach of descriptive statistics, multivariate logistic regression, and a decision tree algorithm provides a thorough understanding of the unique aspects associated with each inflammatory skin disease. This research offers a practical framework for lesion classification, enhancing the interpretability of imaging results for clinicians.

Background Dermal fillers have emerged as a popular non‐surgical solution for facial rejuvenation and enhancement. Apart from botulinum toxin injections, they are the most common non‐surgical procedure performed in the US. Line‐field optical coherence tomography (LC‐OCT; deepLive system Damae Medical, France) represents one of the most recent developments in non‐invasive skin imaging technologies. Materials and methods We performed LC‐OCT image acquisition on six patients that were treated with hyaluronic acid (HA) dermal fillers in various locations on the face. The images were acquired before the application of the fillers (T0), immediately after (T1), and at a 6‐ to 8‐week (T2) follow‐up visit. Results At T0, we were able to appreciate a normal‐appearing epidermis, dermoepithelial junction, and dermis. At T1, the intradermal filler deposits appeared as homogeneously hyporeflective areas, clearly discernible from surrounding vessels and other structures. At T2, the deposits were distinguishable as hyporeflective areas, although they were diminished in size compared to T1. On enface view, collagen fibers had increased thickness and were more homogeneously organized and hyperreflective. Conclusions We established the usefulness of LC‐OCT in the non‐invasive evaluation of dermal HA fillers to visualize both short‐term and medium‐term effects. LC‐OCT may be a valuable tool in evaluating the precise location of filler placement and follow‐up of resulting in vivo changes.

Background The international bowel ultrasound group‐segmental activity score (IBUS‐SAS) is a validated tool with high interobserver agreement for accurately detecting disease activity in Crohn's disease (CD). Here, we addressed whether the IBUS‐SAS is also suitable to assess disease activity in ulcerative colitis (UC). Methods The IBUS‐SAS and Limberg scores were determined in the sigmoid colon of patients with UC. The results were correlated to established scores of clinical, endoscopic and histologic disease activity (partial [pMS] and endoscopic [eMS] Mayo‐Score, ulcerative colitis endoscopic index of severity [UCEIS], histologic Nancy index) and/or biomarkers of inflammation (C‐reactive protein [CRP], fecal calprotectin). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) for IBUS‐SAS and the Limberg score to predict endoscopic and histologic disease activity were computed by receiver operating characteristics (ROC)‐analysis. Results Fifty‐eight patients with UC were enrolled. The median IBUS‐SAS was 34.8. It was significantly correlated with pMS, eMS, UCEIS, Nancy index, CRP and fecal calprotectin. On ROC‐analysis, a cut‐off of 15.9 was reached with 100% sensitivity and 80.0% specificity for the prediction of endoscopic activity, resulting in a PPV of 94.7% and an NPV of 100%. The Limberg score performed only slightly worse (100.0%, 60.0%, 89.9%, 100%, respectively). Comparable results were found regarding the Nancy index for sensitivity (93.9% vs. 93.9%), specificity (57.1% vs. 42.9%), PPV (91.4% vs. 88.9%) and NPV (65.7% vs. 59.0%). Conclusions This study highlights the potential of IUS for the non‐invasive quantification of disease activity in UC and suggests that the IBUS‐SAS should be considered as a diagnostic tool in trials and real‐world management of UC.

Introduction Nose‐to‐brain (N2B) insulin delivery has potential for Alzheimer's disease (AD) therapy. However, clinical implementation has been challenging without methods to follow N2B delivery non‐invasively. Positron emission tomography (PET) was applied to measure F‐18‐labeled insulin ([18F]FB‐insulin) from intranasal dosing to brain uptake in non‐human primates following N2B delivery. Methods [18F]FB‐insulin was prepared by reacting A1,B29‐di(tert‐butyloxycarbonyl)insulin with [18F]‐N‐succinimidyl‐4‐fluorobenzoate. Three methods of N2B delivery for [18F]FB‐insulin were compared – delivery as aerosol via tubing (rhesus macaque, n = 2), as aerosol via preplaced catheter (rhesus macaque, n = 3), and as solution via preplaced catheter (cynomolgus macaque, n = 3). Following dosing, dynamic PET imaging (120 min) quantified delivery efficiency to the nasal cavity and whole brain. Area under the time‐activity curve was calculated for 46 regions of the cynomolgus macaque brain to determine regional [18F]FB‐insulin levels. Results Liquid instillation of [18F]FB‐insulin by catheter outperformed aerosol methods for delivery to the subject (39.89% injected dose vs 10.03% for aerosol via tubing, 0.17% for aerosol by catheter) and subsequently to brain (0.34% injected dose vs 0.00020% for aerosol via tubing, 0.05% for aerosol by catheter). [18F]FB‐insulin was rapidly transferred across the cribriform plate to limbic and frontotemporal areas responsible for emotional and memory processing. [18F]FB‐insulin half‐life was longer in olfactory nerve projection sites with high insulin receptor density compared to the whole brain. Discussion The catheter‐based liquid delivery approach combined with PET imaging successfully tracked the fate of N2B [18F]FB‐insulin and is thought to be broadly applicable for assessments of other therapeutic agents. This method can be rapidly applied in humans to advance clinical evaluation of N2B insulin as an AD therapeutic. Highlights for [18F]FB‐insulin passage across the cribriform plate was detected by PET. Intranasal [18F]FB‐insulin reached the brain within 13 min. [18F]FB‐insulin activity was highest in emotional and memory processing regions. Aerosol delivery was less efficient than liquid instillation by preplaced catheter. Insulin delivery to the cribriform plate was critical for arrival in the brain.

Diagnosing clinically unclear basal cell carcinomas (BCCs) can be challenging. Line-field confocal optical coherence tomography (LC-OCT) is able to display morphological features of BCC subtypes with good histological correlation. The aim of this study was to investigate the accuracy of LC-OCT in diagnosing clinically unsure cases of BCC compared to dermoscopy alone and in distinguishing between superficial BCCs and other BCC subtypes. Moreover, we addressed pitfalls in false positive cases. We prospectively enrolled 182 lesions of 154 patients, referred to our department to confirm or to rule out the diagnosis of BCC. Dermoscopy and LC-OCT images were evaluated by two experts independently. Image quality, LC-OCT patterns and criteria, diagnosis, BCC subtype, and diagnostic confidence were assessed. Sensitivity and specificity of additional LC-OCT were compared to dermoscopy alone for identifying BCC in clinically unclear lesions. In addition, key LC-OCT features to distinguish between BCCs and non-BCCs and to differentiate superficial BCCs from other BCC subtypes were determined by linear regressions. Diagnostic confidence was rated as “high” in only 48% of the lesions with dermoscopy alone compared to 70% with LC-OCT. LC-OCT showed a high sensitivity (98%) and specificity (80%) compared to histology, and these were even higher (100% sensitivity and 97% specificity) in the subgroup of lesions with high diagnostic confidence. Interobserver agreement was nearly perfect (95%). The combination of dermoscopy and LC-OCT reached a sensitivity of 100% and specificity of 81.2% in all cases and increased to sensitivity of 100% and specificity of 94.9% in cases with a high diagnostic confidence. The performance of LC-OCT was influenced by the image quality but not by the anatomical location of the lesion. The most specific morphological LC-OCT criteria in BCCs compared to non-BCCs were: less defined dermoepidermal junction (DEJ), hyporeflective tumor lobules, and dark rim. The most relevant features of the subgroup of superficial BCCs (sBCCs) were: string of pearls pattern and absence of epidermal thinning. Our diagnostic confidence, sensitivity, and specificity in detecting BCCs in the context of clinically equivocal lesions significantly improved using LC-OCT in comparison to dermoscopy only. Operator training for image acquisition is fundamental to achieve the best results. Not only the differential diagnosis of BCC, but also BCC subtyping can be performed at bedside with LC-OCT.

Background Quantitative biomarkers of facial skin aging were investigated in 109 healthy Asian female volunteers, aged 20 to 70 years. Materials and Methods In vivo 3D Line‐field Confocal Optical Coherence Tomography (LC‐OCT) imaging, enhanced by Artificial Intelligence (AI)‐based quantification algorithms, was utilized to compute various metrics, including stratum corneum thickness (SC), viable epidermal (VE) thickness, and Dermal‐Epidermal Junction (DEJ) undulation along with cellular metrics for the temple, cheekbone, and mandible. Results Comparison with data from a cohort of healthy Caucasian volunteers revealed similarities in the variations of stratum corneum and viable epidermis layers, as well as cellular shape and size with age in both ethnic groups. However, specific findings emerged, such as larger, more heterogeneous nuclei in both layers, demonstrated by an increase in nuclei volume and their standard deviation, and increased network atypia, all showing significant age‐related variations. Caucasian females exhibited a flatter and more homogeneous epidermis, evidenced by a decreased standard deviation of the number of layers, and a less dense cellular network with fewer cells per layer, indicated by a decrease in cell surface density. Conclusion Ethnicity‐wise comparisons highlighted distinct biological features specific to each population. Asian individuals showed significantly higher DEJ undulation, higher compactness, and lower cell network atypia compared to their Caucasian counterparts across age groups. Differences in stratum corneum and viable epidermal thickness on the cheekbone were also significant. LC‐OCT 3D imaging provides valuable insights into the aging process in different populations and underscores inherent biological differences between Caucasian and Asian female volunteers.

Until now, the clinical differentiation between a nevus and a melanoma is still challenging in some cases. Line-field confocal optical coherence tomography (LC-OCT) is a new tool with the aim to change that. The aim of the study was to evaluate LC-OCT for the discrimination between nevi and melanomas. A total of 84 melanocytic lesions were examined with LC-OCT and 36 were also imaged with RCM. The observers recorded the diagnoses, and the presence or absence of the 18 most common imaging parameters for melanocytic lesions, nevi, and melanomas in the LC-OCT images. Their confidence in diagnosis and the image quality of LC-OCT and RCM were evaluated. The most useful criteria, the sensitivity and specificity of LC-OCT vs. RCM vs. histology, to differentiate a (dysplastic) nevus from a melanoma were analyzed. Good image quality correlated with better diagnostic performance (Spearman correlation: 0.4). LC-OCT had a 93% sensitivity and 100% specificity compared to RCM (93% sensitivity, 95% specificity) for diagnosing a melanoma (vs. all types of nevi). No difference in performance between RCM and LC-OCT was observed (McNemar’s p value = 1). Both devices falsely diagnosed dysplastic nevi as non-dysplastic (43% sensitivity for dysplastic nevus diagnosis). The most significant criteria for diagnosing a melanoma with LC-OCT were irregular honeycombed patterns (92% occurrence rate; 31.7 odds ratio (OR)), the presence of pagetoid spread (89% occurrence rate; 23.6 OR) and the absence of dermal nests (23% occurrence rate, 0.02 OR). In conclusion LC-OCT is useful for the discrimination between melanomas and nevi.