Quantification of scar margin in keloid different from atrophic scar by multiphoton microscopic imaging.

Multiphoton microscopy (MPM) was applied to examine the marginal region at dermis of keloid compared with atrophic scar. High-resolution large-area image showed an obvious boundary at the scar margin and different morphological patterns of elastin and collagen on the two sides, further visualized by the focused three-dimensional images. Content alteration of elastin or collagen between the two sides of boundary was quantified to show significant difference between keloid and atrophic scar. Owing to the raised property of keloid with overproduced collagen on the scar side, the content alteration was positive for elastin and negative for collagen. On the contrary, the content alteration was negative for elastin and positive for collagen in the atrophic scar case due to the atrophic collagen on the scar side. It indicated that examination of the scar margin by MPM may lead a new way to discriminate different types of scars and better understand the scarring mechanisms.

[1]  Michael S Roberts,et al.  Analysis of the metabolic deterioration of ex vivo skin from ischemic necrosis through the imaging of intracellular NAD(P)H by multiphoton tomography and fluorescence lifetime imaging microscopy. , 2010, Journal of biomedical optics.

[2]  W. Webb,et al.  Nonlinear magic: multiphoton microscopy in the biosciences , 2003, Nature Biotechnology.

[3]  Bishara S Atiyeh,et al.  Keloid or Hypertrophic Scar: The Controversy: Review of the Literature , 2005, Annals of plastic surgery.

[4]  A. Utani,et al.  Elastic fiber assembly is disrupted by excessive accumulation of chondroitin sulfate in the human dermal fibrotic disease, keloid. , 2009, Biochemical and biophysical research communications.

[5]  A. Singer,et al.  Cutaneous wound healing. , 1999, The New England journal of medicine.

[6]  Facd,et al.  Postacne Scarring: A Review of its Pathophysiology and Treatment , 2000, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[7]  Chung-Ho Sun,et al.  Modeling aberrant wound healing using tissue-engineered skin constructs and multiphoton microscopy. , 2004, Archives of facial plastic surgery.

[8]  Shuangmu Zhuo,et al.  Multimode nonlinear optical imaging of the dermis in ex vivo human skin based on the combination of multichannel mode and Lambda mode. , 2006, Optics express.

[9]  Karsten König,et al.  Clinical application of multiphoton tomography in combination with high‐frequency ultrasound for evaluation of skin diseases , 2010, Journal of biophotonics.

[10]  D. Sampson,et al.  Contrast and depth enhancement in two-photon microscopy of human skin ex vivo by use of optical clearing agents. , 2005, Optics express.

[11]  E. Middelkoop,et al.  Development of an in vitro burn wound model , 2008, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[12]  W. Denk,et al.  Two-photon imaging to a depth of 1000 microm in living brains by use of a Ti:Al2O3 regenerative amplifier. , 2003, Optics letters.

[13]  Karsten König,et al.  Imaging of cardiovascular structures using near-infrared femtosecond multiphoton laser scanning microscopy. , 2005, Journal of biomedical optics.

[14]  A Bayat,et al.  Skin scarring , 2003, BMJ : British Medical Journal.

[15]  Karsten König,et al.  In vivo measurement of the human epidermal thickness in different localizations by multiphoton laser tomography , 2010, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[16]  K. König,et al.  [Multiphoton microscopy and in vivo tomography in dermatologic imaging]. , 2010, Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete.

[17]  X. Jiang,et al.  Differentiating keloids from normal and hypertrophic scar based on multiophoton microscopy , 2010 .

[18]  A. Ormsby,et al.  A light microscopic and immunohistochemical evaluation of scars , 2002, Journal of cutaneous pathology.

[19]  Stefan Puschmann,et al.  Risk estimation of skin damage due to ultrashort pulsed, focused near-infrared laser irradiation at 800 nm. , 2008, Journal of biomedical optics.

[20]  M. Kaatz,et al.  Multiphotonenmikroskopie und In-vivo-Multiphotonentomographie in der dermatologischen Bildgebung , 2010, Der Hautarzt.

[21]  M Kon,et al.  On the nature of hypertrophic scars and keloids: a review. , 1999, Plastic and reconstructive surgery.

[22]  A. Bailey,et al.  Prognostic value of markers of collagen remodeling in venous ulcers , 1999, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[23]  Xiaoqin Zhu,et al.  Characteristics of scar margin dynamic with time based on multiphoton microscopy , 2011, Lasers in Medical Science.

[24]  Karsten König,et al.  Sensitivity and specificity of multiphoton laser tomography for in vivo and ex vivo diagnosis of malignant melanoma. , 2009, The Journal of investigative dermatology.

[25]  Chen-Yuan Dong,et al.  Evaluating cutaneous photoaging by use of multiphoton fluorescence and second-harmonic generation microscopy. , 2005, Optics letters.

[26]  Chung-Ho Sun,et al.  Nondestructive imaging of live human keloid and facial tissue using multiphoton microscopy. , 2008, Archives of facial plastic surgery.

[27]  S. Xie,et al.  Nonlinear spectral imaging of human hypertrophic scar based on two‐photon excited fluorescence and second‐harmonic generation , 2009, The British journal of dermatology.

[28]  M. Longaker,et al.  Current progress in keloid research and treatment. , 2008, Journal of the American College of Surgeons.

[29]  K. Arndt,et al.  Scar management: keloid, hypertrophic, atrophic, and acne scars. , 2002, Seminars in cutaneous medicine and surgery.

[30]  Barry Cense,et al.  Advances in optical coherence tomography imaging for dermatology. , 2004, The Journal of investigative dermatology.

[31]  N. Orentreich,et al.  Subcutaneous Incisionless (Subcision) Surgery for the Correction of Depressed Scars and Wrinkles , 1995, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[32]  Roberto E. Mancini,et al.  Histogenesis of experimentally produced keloids. , 1962 .

[33]  Timo Tervo,et al.  In vivo confocal microscopy for evaluation of wound healing following corneal refractive surgery , 2003, Progress in Retinal and Eye Research.

[34]  N. Occleston,et al.  New therapeutics for the prevention and reduction of scarring. , 2008, Drug discovery today.