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Vol. 4, No. 1, 2012
Issue release date: January – April
Section title: Published: January 2012

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Case Rep Dermatol 2012;4:14–18
(DOI:10.1159/000336000)

Imaging Granulomatous Lesions with Optical Coherence Tomography

Banzhaf C. · Jemec G.B.E.
Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
email Corresponding Author

Christina Banzhaf

Department of Dermatology, Roskilde HospitalKøgevej 7–13

DK–4000 Roskilde (Denmark)

Tel. +45 4632 2672, E-Mail cfrd@regionsjaelland.dk

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Abstract

Aim: To investigate and compare the presentation of granulomatous lesions in optical coherence tomography (OCT) images and compare this to previous studies of nonmelanoma skin tumors. Methods: Two patients with granulomas, tophi and granuloma annulare (GA), respectively, were photographed digitally, OCT-scanned and biopsied in the said order. Normal skin was OCT-scanned for comparison, but not biopsied. The OCT images from each lesion were compared with their histologic images as well as with OCT images with similar characteristics obtained from nonmelanoma skin tumors. Results: The OCT images of the tophi showed hyperreflective, rounded cloud-like structures in dermis, their upper part sharply delineated by a hyporeflective fringe. The deeper areas appeared blurred. The crystalline structures were delineated by a hyporeflective fringe. OCT images of GA showed two different structures in dermis: a hyporeflective rounded one, and one that was lobulated and wing-like. Conclusion: Granulomatous tissue surrounding urate deposits appeared as a clear hyporeflective fringe surrounding a light, hyperreflective area. The urate crystals appeared as hyperreflective areas, shielding the deeper part of dermis, meaning OCT could only visualize the upper part of the lesions. The lobulated, wing-like structure in GA may resemble diffuse GA or a dense lymphocytic infiltrate as seen on histology. The rounded structure in GA may represent an actual granuloma or either diffuse GA or a dense lymphocytic infiltrate as described above. This case suggests that OCT images granulomatous tissue as absorbent, hyporeflective areas, and urate crystals appear as reflective areas, obscuring the underlying tissue. In GA a new image shape looking like a wing has been found. The frequency, specificity and sensitivity of this new pattern in OCT imaging will require further studies.

© 2012 S. Karger AG, Basel


  

Author Contacts

Christina Banzhaf
Department of Dermatology, Roskilde HospitalKøgevej 7–13
DK–4000 Roskilde (Denmark)
Tel. +45 4632 2672, E-Mail cfrd@regionsjaelland.dk

  

Article Information

Published online: January 30, 2012
Number of Print Pages : 5
Number of Figures : 2,
Additional supplementary material is available online - Number of Parts : 1

  

Publication Details

Case Reports in Dermatology

Vol. 4, No. 1, Year 2012 (Cover Date: January - April)

Journal Editor: Jemec G.B.E. (Roskilde)
ISSN: NIL (Print), eISSN: 1662-6567 (Online)

For additional information: http://www.karger.com/CDE


Article / Publication Details

First-Page Preview
Abstract of Published: January 2012

Published online: 1/30/2012
Issue release date: January – April

Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 0

ISSN: (Print)
eISSN: 1662-6567 (Online)

For additional information: http://www.karger.com/CDE


Open Access License / Drug Dosage / Disclaimer

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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