In vivo two-photon-excited cellular fluorescence of melanin, NAD(P)H, and keratin enables an accurate differential diagnosis of seborrheic keratosis and pigmented cutaneous melanoma

• Verfasst von: Szyc, Łukasz [VerfasserIn]
• Verfasst von: Scharlach, Constantin [VerfasserIn]
• Verfasst von: Hänßle, Holger [VerfasserIn]
• Verfasst von: Müller-Christmann, Christine [VerfasserIn]
• Titel: In vivo two-photon-excited cellular fluorescence of melanin, NAD(P)H, and keratin enables an accurate differential diagnosis of seborrheic keratosis and pigmented cutaneous melanoma
• Verf.angabe: Lukasz Szyc, Constantin Scharlach, Holger Haenssle, and Christine Fink
• E-Jahr: 2021
• Jahr: Jul. 14, 2021
• Umfang: 9 S.
• Fussnoten: Gesehen am 30.09.2021
• Titel Quelle: Enthalten in: Journal of biomedical optics
• Ort Quelle: Bellingham, Wash. : SPIE, 1996
• Jahr Quelle: 2021
• Band/Heft Quelle: 26(2021), 7, Seite i075002$p1-9
• ISSN Quelle: 1560-2281
• DOI: doi:10.1117/1.JBO.26.7.075002
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1772160849

Abstract

Significance: Seborrheic keratoses (SKs) are harmless pigmented skin lesions (PSLs) that may be confused clinically not only with other benign conditions but also with cutaneous melanoma (CM). As SKs are one of the most common neoplasms in adults, the importance of their correct diagnosis is high. Misclassifying SK as malignant is not rare and leads to a high number of unnecessary biopsies. On the other hand, misdiagnosing CM as SK may have a large impact on prognosis or therapy. Aim: In the non-invasive technique of dermatofluoroscopy, the fluorophores in melanocytes and keratinocytes are excited in vivo with nanosecond laser pulses and the resulting spectrally resolved, melanin-dominated fluorescence signals are used to differentiate between pigmented benign lesions and CM. Approach: In this single-center, non-interventional study, 33 PSLs of 20 patients were scanned with dermatofluoroscopy in vivo. For all included cases, dermatofluoroscopic signals were compared to pathology classification. Results: The characteristic spectral features of SK were identified, where the signals are dominated by keratin, NAD(P)H, and melanin. The fluorescence spectra of SKs differed substantially from those of CM: a characteristic spectrum of SK has been identified in 27 of 28 SKs. Conclusions: The high-accuracy differential diagnosis between CM and SK is possible with dermatofluoroscopy.