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Traditional biopsy procedures require invasive tissue removal from a living subject, followed by time-consuming and complicated processes, so noninvasive in vivo virtual biopsy, which possesses the ability to obtain exhaustive tissue images without removing tissues, is highly desired. Some sets of in vivo virtual biopsy images provided by healthy volunteers were processed by the proposed cell segmentation approach, which is based on the watershed-based approach and the concept of convergence index filter for automatic cell segmentation. Experimental results suggest that the proposed algorithm not only reveals high accuracy for cell segmentation but also has dramatic potential for noninvasive analysis of cell nuclear-to-cytoplasmic ratio (NC ratio), which is important in identifying or detecting early symptoms of diseases with abnormal NC ratios, such as skin cancers during clinical diagnosis via medical imaging analysis. [ABSTRACT FROM PUBLISHER]

Melanin is known to provide strong third-harmonic generation (THG) contrast in human skin. With a high concentration in basal cell cytoplasm, THG contrast provided by melanin overshadows other THG sources in human skin studies. For better understanding of the THG signals in keratinocytes without the influence of melanin, an in vivo THG microscopy (THGM) study was first conducted on vitiliginous skin. As a result, the THG-brightness ratio between the melanin-lacking cytoplasm of basal cells and collagen fibers is about 1.106 at the dermal–epidermal junctions of vitiliginous skin, indicating high sensitivity of THGM for the presence of melanin. We further applied the in vivo THGM to assist evaluating the therapeutic outcome from the histopathological point of view for those showed no improvement under narrowband ultraviolet B therapy based on the seven-point Physician Global Assessment score. Our clinical study indicates the high potential of THGM to assist the histopathological assessment of the therapeutic efficacy of vitiligo treatments. [ABSTRACT FROM AUTHOR]

Evaluates the pathology of micropapular sarcoidosis. Details on a case report of a patient with sarcoidosis; Effect of oral prednisolone on lesion formation; Difference between micorpapular sarcoidosis and lichen scrofulosorum.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder associated with tunnel formation and scarring. Surgical excision is a potential curative therapy for HS., Objectives: To characterize the surgical outcomes of patients with HS undergoing complete excision and to identify the risk factors associated with postoperative recurrence., Methods: This retrospective 16-year cohort study enrolled patients ≥ 20 years who underwent complete excision for HS lesions at the National Taiwan University Hospital. We assessed the rates of postsurgical recurrence and complications and estimated the odds ratio (ORs) with 95% confidence intervals (CIs) of their association with potential risk factors using generalized estimating equations., Results: In total, 136 patients with HS and the 284 corresponding complete excisions were identified. Recurrence developed in 88 of 284 (31.0%) operations and complications occurred in 102 (35.9%). Common types of complications included wound dehiscence, hypertrophic scars and surgical-site infection. Clinical factors associated with a lower risk of recurrence were male sex [adjusted OR (aOR) 0.48, 95% CI 0.23-0.98], surgery at atypical body sites (aOR 0.28, 95% CI 0.08-0.99) and wound repair by split-thickness skin graft (aOR 0.31, 95% CI 0.12-0.77). Wound dehiscence was associated with an increased risk of recurrence (aOR 2.55, 95% CI 1.21-5.42). No independent factors were identified as being associated with composite postoperative complications., Conclusions: Complete excision alone can be effective in curing HS in Asian populations. Recurrence developed in about one-third of the complete excisions performed for HS. Sex, surgical body sites, methods of wound repair and wound dehiscence were major determinants for recurrence., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Hidradenitis suppurativa (HS) is a chronic inflammatory follicular disease characterized by painful, recurrent, inflamed lesions most commonly occurring in the axillary, inguinal, and anogenital regions. HS can inflict immense physical and psychological impact on patients who suffer from this distressing disease. Management of HS generally requires combining various medical and procedural treatment modalities; however, the disease is often recalcitrant to conventional treatments. In light of recent evidence supporting the effectiveness of biologic agents in the treatment of HS, the Taiwanese Dermatological Association established an expert panel of nine dermatologists to develop consensus statements aimed to provide up-to-date evidence-based guidance in optimizing HS patient management in Taiwan. The recommendations described in the statements were summarized in a management algorithm in terms of general care, topical treatment, systemic treatment, and procedural treatment., (Copyright © 2023 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Morphology and distribution of melanocytes are critical imaging information for the diagnosis of melanocytic lesions. However, how to image intratumoral melanocytes noninvasively in pigmented skin tumors is seldom investigated. Third-harmonic generation (THG) is shown to be enhanced by melanin, whereas high accuracy has been demonstrated using THG microscopy for in vivo differential diagnosis of nonmelanocytic pigmented skin tumors. It is thus desirable to investigate if label-free THG microscopy was capable to in vivo identify intratumoral melanocytes. In this study, histopathological correlations of label-free THG images with the immunohistochemical images stained with human melanoma black (HMB)-45 and cluster of differentiation 1a (CD1a) were made. The correlation results indicated that the intratumoral THG-bright dendritic-cell-like signals were endogenously derived from melanocytes rather than Langerhans cells (LCs). The consistency between THG-bright dendritic-cell-like signals and HMB-45 melanocyte staining showed a kappa coefficient of 0.807, 84.6% sensitivity, and 95% specificity. In contrast, a kappa coefficient of −0.37, 21.7% sensitivity, and 30% specificity were noted between the THG-bright dendritic-cell-like signals and CD1a staining for LCs. Our study indicates the capability of noninvasive label-free THG microscopy to differentiate intratumoral melanocytes from LCs, which is not feasible in previous in vivo label-free clinical-imaging modalities.

Third-harmonic generation (THG) microscopy has been reported to provide intrinsic contrast in elastic fibers, cytoplasmic membrane, nucleus, actin filaments, lipid bodies, hemoglobin, and melanin in human skin. For advanced molecular imaging, exogenous contrast agents are developed for a higher structural or molecular specificity. We demonstrate the potential of the commonly adopted tattoo dye as a THG contrast agent for in vivo optical biopsy of human skin. Spectroscopy and microscopy experiments were performed on cultured cells with tattoo dyes, in tattooed mouse skin, and in tattooed human skin to demonstrate the THG enhancement effect. Compared with other absorbing dyes or nanoparticles used as exogenous THG contrast agents, tattoo dyes are widely adopted in human skin so that future clinical biocompatibility evaluation is relatively achievable. Combined with the demonstrated THG enhancement effect, tattoo dyes show their promise for future clinical imaging applications.