Characterizing the microcirculation of atopic dermatitis using angiographic optical coherence tomography

Background and Aim: With inflammatory skin conditions such as atopic dermatitis (AD), epidermal thickness is mediated by both pathological hyperplasia and atrophy such as that resulting from corticosteroid treatment. Such changes are likely to influence the depth and shape of the underlying microcirculation. Optical coherence tomography (OCT) provides a non-invasive view into the tissue, however structural measures of epidermal thickness are made challenging due to the lack of a delineated dermal-epidermal junction in AD patients. Instead, angiographic extensions to OCT may allow for direct measurement of vascular depth, potentially presenting a more robust method of estimating the degree of epidermal thickening. Methods and results: To investigate microcirculatory changes within AD patients, volumes of angiographic OCT data were collected from 5 healthy volunteers and compared to that of 5 AD patients. Test sites included the cubital and popliteal fossa, which are commonly affected by AD. Measurements of the capillary loop and superficial arteriolar plexus (SAP) depth were acquired and used to estimate the lower and upper bounds of the undulating basement membrane of the dermal-epidermal junction. Furthermore, quantitative parameters such as vessel density and diameter were derived from each dataset and compared between groups. Capillary loop depth increased slightly for AD patients at the poplitial fossa and SAP was found to be measurably deeper in AD patients at both sites, likely due to localized epidermal hyperplasia.