Vascular Characteristics of Treatment-resistant and -responsive Actinic Keratosis Identified with Dynamic Optical Coherence Tomography

Treatment-resistant actinic keratosis (AK) is of concern in clinical practice, often requiring retreatment. Microvascular assessments might help differentiate treatment-resistant from treatment-responsive AKs, enabling targeted treatment. Using dynamic optical coherence tomography, AK vascularizatio...

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Main Authors: Gabriella Fredman, Merete Haedersdal, Peter A. Philipsen, Flemming Andersen, Peter Bjerring, Stine R. Wiegell, Gavrielle Untracht
Format: Article
Language:English
Published: Medical Journals Sweden 2024-11-01
Series:Acta Dermato-Venereologica
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Online Access:https://medicaljournalssweden.se/actadv/article/view/42190
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author Gabriella Fredman
Merete Haedersdal
Peter A. Philipsen
Flemming Andersen
Peter Bjerring
Stine R. Wiegell
Gavrielle Untracht
author_facet Gabriella Fredman
Merete Haedersdal
Peter A. Philipsen
Flemming Andersen
Peter Bjerring
Stine R. Wiegell
Gavrielle Untracht
author_sort Gabriella Fredman
collection DOAJ
description Treatment-resistant actinic keratosis (AK) is of concern in clinical practice, often requiring retreatment. Microvascular assessments might help differentiate treatment-resistant from treatment-responsive AKs, enabling targeted treatment. Using dynamic optical coherence tomography, AK vascularization was investigated following daylight photodynamic therapy, comparing treatment-resistant with cleared AKs. AKs on face/scalp were graded according to the Olsen Classification Scheme and scanned with dynamic optical coherence tomography pre-treatment, and 3- and 12-months post-treatment. Employing dynamic optical coherence tomography, total vessel length, mean vessel length, mean vessel diameter, vessel area density, and branchpoint density were quantified. Thirty-eight patients with 62 AKs were enrolled, including 37 AK I, 18 AK II, and 7 AK III. Treatment-resistant AKs displayed a trend toward intensified vascularization compared with cleared AK at baseline (AKs I, II), suggested by higher total vessel length (median 144.0, IQR 104.3–186.6) and vessel area density (median 27.7, IQR 18.4–34.2) than in cleared AK (median 120.9, IQR 86.9–143.0 and median 22.9, IQR 17.3–26.8). Additionally, vascularization in treatment-resistant AK I–II appeared disorganized, with trends toward shorter mean vessel length (median 151.0, IQR 138.5–167.5) and increased branchpoint density (median 3.2, IQR 2.3–3.8) compared with cleared AK (median 160.0, IQR 152.0–169.3 and median 2.6, IQR 2.2–3.0). These findings suggest that dynamic optical coherence tomography holds potential to identify treatment-resistant AKs.
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spelling doaj-art-e64137f6ab664d5988f10c7ba33302a12024-11-25T14:30:39ZengMedical Journals SwedenActa Dermato-Venereologica0001-55551651-20572024-11-0110410.2340/actadv.v104.42190Vascular Characteristics of Treatment-resistant and -responsive Actinic Keratosis Identified with Dynamic Optical Coherence TomographyGabriella Fredman0https://orcid.org/0000-0003-3903-2651Merete Haedersdal1Peter A. Philipsen2Flemming Andersen3Peter Bjerring4Stine R. Wiegell5Gavrielle Untracht6Department of Dermatology, Copenhagen University Hospital, Bispebjerg, Copenhagen, DenmarkDepartment of Dermatology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, DenmarkDepartment of Dermatology, Copenhagen University Hospital, Bispebjerg, Copenhagen, DenmarkSkin Center Mølholm, Private Hospital Mølholm, Vejle, Denmark; Department of Dermatology, Aalborg University Hospital, Aalborg, DenmarkSkin Center Mølholm, Private Hospital Mølholm, Vejle, Denmark; Department of Dermatology, Aalborg University Hospital, Aalborg, DenmarkDepartment of Dermatology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, DenmarkDepartment of Dermatology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark; Department of Health Technology, Technical University of Denmark, Kongens Lyngby, DenmarkTreatment-resistant actinic keratosis (AK) is of concern in clinical practice, often requiring retreatment. Microvascular assessments might help differentiate treatment-resistant from treatment-responsive AKs, enabling targeted treatment. Using dynamic optical coherence tomography, AK vascularization was investigated following daylight photodynamic therapy, comparing treatment-resistant with cleared AKs. AKs on face/scalp were graded according to the Olsen Classification Scheme and scanned with dynamic optical coherence tomography pre-treatment, and 3- and 12-months post-treatment. Employing dynamic optical coherence tomography, total vessel length, mean vessel length, mean vessel diameter, vessel area density, and branchpoint density were quantified. Thirty-eight patients with 62 AKs were enrolled, including 37 AK I, 18 AK II, and 7 AK III. Treatment-resistant AKs displayed a trend toward intensified vascularization compared with cleared AK at baseline (AKs I, II), suggested by higher total vessel length (median 144.0, IQR 104.3–186.6) and vessel area density (median 27.7, IQR 18.4–34.2) than in cleared AK (median 120.9, IQR 86.9–143.0 and median 22.9, IQR 17.3–26.8). Additionally, vascularization in treatment-resistant AK I–II appeared disorganized, with trends toward shorter mean vessel length (median 151.0, IQR 138.5–167.5) and increased branchpoint density (median 3.2, IQR 2.3–3.8) compared with cleared AK (median 160.0, IQR 152.0–169.3 and median 2.6, IQR 2.2–3.0). These findings suggest that dynamic optical coherence tomography holds potential to identify treatment-resistant AKs. https://medicaljournalssweden.se/actadv/article/view/42190dynamic optical coherence tomographydaylight photodynamic therapyactinic keratosisskin microvasculatureangiographyOCTAVA
spellingShingle Gabriella Fredman
Merete Haedersdal
Peter A. Philipsen
Flemming Andersen
Peter Bjerring
Stine R. Wiegell
Gavrielle Untracht
Vascular Characteristics of Treatment-resistant and -responsive Actinic Keratosis Identified with Dynamic Optical Coherence Tomography
Acta Dermato-Venereologica
dynamic optical coherence tomography
daylight photodynamic therapy
actinic keratosis
skin microvasculature
angiography
OCTAVA
title Vascular Characteristics of Treatment-resistant and -responsive Actinic Keratosis Identified with Dynamic Optical Coherence Tomography
title_full Vascular Characteristics of Treatment-resistant and -responsive Actinic Keratosis Identified with Dynamic Optical Coherence Tomography
title_fullStr Vascular Characteristics of Treatment-resistant and -responsive Actinic Keratosis Identified with Dynamic Optical Coherence Tomography
title_full_unstemmed Vascular Characteristics of Treatment-resistant and -responsive Actinic Keratosis Identified with Dynamic Optical Coherence Tomography
title_short Vascular Characteristics of Treatment-resistant and -responsive Actinic Keratosis Identified with Dynamic Optical Coherence Tomography
title_sort vascular characteristics of treatment resistant and responsive actinic keratosis identified with dynamic optical coherence tomography
topic dynamic optical coherence tomography
daylight photodynamic therapy
actinic keratosis
skin microvasculature
angiography
OCTAVA
url https://medicaljournalssweden.se/actadv/article/view/42190
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