Non-invasive imaging of pathological scars using a portable handheld two-photon microscope

Background:Pathological scars are a disorder that can lead to various cosmetic,psychological,and functional problems,and no effective assessment methods are currently available.Assessment and treatment of pathological scars are based on cutaneous manifestations.A two-photon microscope(TPM)with the potential for real-time non-invasive assessment may help determine the under-surface pathophysiological conditions in vivo.This study used a portable handheld TPM to image epidermal cells and dermal collagen structures in pathological scars and normal skin in vivo to evaluate the effectiveness of treatment in scar patients.Methods:Fifteen patients with pathological scars and three healthy controls were recruited.Imaging was performed using a portable handheld TPM.Five indexes were extracted from two dimensional(2D)and three dimensional(3D)perspectives,including collagen depth,dermo-epidermal junction(DEJ)contour ratio,thickness,orientation,and occupation(proportion of collagen fibers in the field of view)of collagen.Two depth-dependent indexes were computed through the 3D second harmonic generation image and three morphology-related indexes from the 2D images.We assessed index differences between scar and normal skin and changes before and after treatment.Results:Pathological scars and normal skin differed markedly regarding the epidermal morphological structure and the spectral characteristics of collagen fibers.Five indexes were employed to distinguish between normal skin and scar tissue.Statistically significant differences were found in average depth(t=9.917,P<0.001),thickness(t=4.037,P<0.001),occupation(t=2.169,P<0.050),orientation of collagen(t=3.669,P<0.001),and the DEJ contour ratio(t=5.105,P<0.001).Conclusions:Use of portable handheld TPM can distinguish collagen from skin tissues;thus,it is more suitable for scar imaging than reflectance confocal microscopy.Thus,a TPM may be an auxiliary tool for scar treatment selection and assessing treatment efficacy.

Deficiency of two-pore segment channel 2 contributes to systemic lupus erythematosus via regulation of apoptosis and cell cycle

Background:Systemic lupus erythematosus(SLE)is a complex autoimmune disease,and the mechanism of SLE is yet to be fully elucidated.The aim of this study was to explore the role of two-pore segment channel 2(TPCN2)in SLE pathogenesis.Methods:Quantitative reverse transcription polymerase chain reaction(qRT-PCR)was used to detect the expression ofTPCN2 in SLE.We performed a loss-of-function assay by lentiviral construct in Jurkat and THP-1 cell.Knockdown ofTPCN2 were confirmed at the RNA level by qRT-PCR and protein level by Western blotting.Cell Count Kit-8 and flow cytometry were used to analyze the cell proliferation,apoptosis,and cell cycle ofTPCN2-deficient cells.In addition,gene expression profile ofTPCN2-deficient cells was analyzed by RNA sequencing(RNA-seq).Results:TPCN2 knockdown with short hairpin RNA(shRNA)-mediated lentiviruses inhibited cell proliferation,and induced apoptosis and cell-cycle arrest of G2/M phase in both Jurkat and THP-1 cells.We analyzed the transcriptome of knockdown-TPCN2-Jurkat cells,and screened the differential genes,which were enriched for the G2/M checkpoint,complement,and interleukin-6-Janus kinase-signal transducer and activator of transcription pathways,as well as changes in levels of forkhead box O,phosphatidylinositol 3-kinase/protein kinase B/mechanistic target of rapamycin,and T cell receptor pathways;moreover,TPCN2 significantly influenced cellular processes and biological regulation.Conclusion:TPCN2 might be a potential protective factor against SLE.

Summarization and comparison of dermoscopic features on different subtypes of rosacea

Background:The dermoscopic features of rosacea have already been reported.However,the current findings are incomplete,and little is known about phymatous rosacea.Hence,this study aimed to summarize and compare the dermoscopic features and patterns of three rosacea subtypes(erythematotelangiectatic[ETR],papulopustular[PPR],and phymatous[PHR])in the Chinese Han population and to evaluate whether these features differ with patients’genders,ages,and durations.Methods:Dermoscopic images of 87 rosacea patients were collected in non-polarized and polarized dermoscopy contact modes at 20-fold magnification.Dermoscopic features,including vessels,scales,follicular findings,and other structures,were summarized and evaluated.Results::The reticular linear vessels and red diffuse structureless areas of ETR were distinctive.For PPR,red diffuse structureless areas,reticular linear vessels,yellow scales,follicular plugs,and follicular pustules were typical dermoscopic criteria.The common dermoscopic features of PHR were:orange diffuse structureless areas,linear vessels with branches,perifollicular white color,orange focal structureless areas,and white lines.The following features statistically differed among the three rosacea subtypes:reticular linear vessels(P<0.001),unspecific linear vessels(P=0.005),linear vessels with branches(P<0.001),yellow scales(P=0.001),follicular plugs(P<0.001),perifollicular white color(P<0.001),red diffuse structureless areas(P=0.022),orange diffuse structureless areas(P<0.001),red focal structureless areas(P=0.002),orange focal structureless areas(P=0.003),white lines(P<0.001),follicular pustules(P<0.001),and black vellus hairs(P<0.001).Conclusions:The dermoscopic patterns of ETR are red diffuse structureless areas and reticular linear vessels.For PPR,the pattern comprehends combinations of red diffuse structureless areas,reticular linear vessels,yellow scales,follicular plugs,and follicular pustules.Meanwhile,PHR is characterized by remarkable orange diffuse structureless areas,linear vessels with branches,perifollicular white color,orange focal structureless areas,and white lines.

Construction of an artificial intelligence system in dermatology: effectiveness and consideration of Chinese Skin Image Database (CSID)

After more than 60 years of development,artificial intelligence(AI)has been widely used in various fields.Especially in recent years,with the development of deep learning,AI has made many remarkable achievements in the medical field.Dermatology,as a clinical discipline with morphology as its main feature,is particularly suitable for the development of AI.The rapid development of skin imaging technology has helped dermatologists to assist in the diagnosis of diseases and has greatly improved the accuracy of diagnosis.Skin imaging data have natural big data attributes,which is important for AI research.The establishment of the Chinese Skin Image Database(CSID)has solved many problems such as isolated data islands and inconsistent data quality.Based on the CSID,many pioneering achievements have been made in the research and development of AI-assisted decision-making software,the establishment of expert organizations,personnel training,scientific research,and so on.At present,there are still many problems with AI in the field of dermatology,such as clinical validation,medical device licensing,interdisciplinary,and standard formulation,which urgently need to be solved by joint efforts of all parties.