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Review
. 2024 Jan 23;16(3):484.
doi: 10.3390/cancers16030484.

Digitally Enhanced Methods for the Diagnosis and Monitoring of Treatment Responses in Actinic Keratoses: A New Avenue in Personalized Skin Care

Cristina Soare  1 , Elena Codruta Cozma  2   3 , Ana Maria Celarel  3 , Ana Maria Rosca  4 , Mihai Lupu  1 , Vlad Mihai Voiculescu  1   3
Affiliations
Review

Digitally Enhanced Methods for the Diagnosis and Monitoring of Treatment Responses in Actinic Keratoses: A New Avenue in Personalized Skin Care

Cristina Soare et al. Cancers (Basel). .

Abstract

Non-melanocytic skin cancers represent an important public health problem due to the increasing incidence and the important local destructive potential. Thus, the early diagnosis and treatment of precancerous lesions (actinic keratoses) is a priority for the dermatologist. In recent years, non-invasive skin imaging methods have seen an important development, moving from simple observational methods used in clinical research, to true diagnostic and treatment methods that make the dermatologist's life easier. Given the frequency of these precancerous lesions, their location on photo-exposed areas, as well as the long treatment periods, with variable, imprecise end-points, the need to use non-invasive imaging devices is increasingly evident to complete the clinical observations in the diagnosis and treatment of these lesions, with the aim of increasing accuracy and decreasing the adverse effects due to long treatment duration. This is the first review that brings together all skin imaging methods (dermoscopy, reflectance confocal microscopy, ultrasonography, dermoscopy-guided high frequency ultrasonography, and optical coherence tomography) used in the evaluation of actinic keratoses and their response to different treatment regimens.

Keywords: actinic keratosis; dermoscopy; dermoscopy guided high frequency ultrasonography; optical coherence tomography; reflectance confocal microscopy; skin imaging.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Dermoscopic aspects of actinic keratosis. Red pseudo-network with erythema in the background, interrupted by the follicular openings; yellow scales in the surface (blue arrows), slightly curved, wavy vessels (grey arrows) (a,b); erosion (red arrow) (b); Images from the personal library of VMV obtained with Casio DZ-D100 device (Dermoscopy Mode).
Figure 2
Figure 2
Reflectance confocal microscopy aspects of actinic keratosis at the level of spinous and granular layers—atypical honeycomb patterns with keratinocytes variable in size and morphology (blue arrows) (a–c); small hyperreflective cells corresponding to inflammatory cells (orange arrows) (a,c); Images from the personal library of VMV obtained with the VivaScope handheld 3000 device.
Figure 3
Figure 3
Reflectance confocal microscopy aspects of actinic keratosis at the level of dermis; hyperreflective collagen bundles which interconnects in a disarray pattern (green arrow); moderately refractive lace-like material adjacent to collagen bundles; small bright cells corresponding to inflammatory cells (orange arrows); dilated blood vessels. Images from the personal library of VMV obtained using a VivaScope handheld 3000 device.
Figure 4
Figure 4
Dermoscopy-Guided High-Frequency Ultrasound images at the level of an actinic keratosis grade II–III. Images from the personal library of VMV obtained using the Dermus Vision Device (Skin Aid Software, 2023).
Figure 5
Figure 5
Dermoscopy-Guided High-Frequency Ultrasound images at the level of an actinic keratosis grade I–II. Images from the personal library of Voiculescu VM obtained using the Dermus Vision Device (Skin Aid Software, 2023).
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Grants and funding

The APC was funded by The Foundation of Cellular and Molecular Medicine, Bucharest.

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