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Insight in Human Skin Microcirculation Using In Vivo Reflectance-Mode Confocal Laser Scanning Microscopy

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Abstract

Reflectance-mode confocal laser scanning microscopy allows in vivo imaging of the human skin. We hypothesized that this high-resolution technique enables observation of dynamic changes of the cutaneous microcirculation. Twenty-two volunteers were randomly divided in two groups. Group 1 was exposed to local heating and group 2 to local cold stress. Confocal microscopy was performed prior t 0 (control), directly t 1 and 5 min t 2 after local temperature changes to evaluate quantitative blood cell flow, capillary loop diameter, and density of dermal capillaries. In group 1, blood flow increased at t 1 (75.82 ± 2.86/min) and further at t 2 (84.09 ± 3.39/min) compared to the control (61.09 ± 3.21/min). The control capillary size was 9.59 ± 0.25 μm, increased to 11.16 ± 0.21 μm (t 1) and 11.57 ± 0.24 μm (t 2). The dermal capillary density increased in t 1 (7.26 ± 0.76/mm2) and t 2 (8.16 ± 0.52/mm2), compared to the control (7.04 ± 0.62/mm2). In group 2, blood flow decreased at t 1 (41.73 ± 2.61/min) and increased at t 2 (83.27 ± 3.29/min) compared to the control (60.73 ± 2.90/min). The control capillary size was 9.55 ± 0.25 μm, decreased at t 1 (7.78 ± 0.26 μm) and increased at t 2 (11.38 ± 0.26 μm). Capillary density decreased at t 1 (5.01 ± 0.49/mm2) and increased at t 2 (7.28 ± 0.53/mm2) compared to the control (7.01 ± 0.52/mm2). Confocal microscopy is a sensitive and noninvasive imaging tool for characterizing and quantifying dynamic changes of cutaneous microcirculation on a histomorphological level.

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References

  1. Alvarez GE, Zhao K, Kosiba WA, Johnson JM: Relative roles of local and reflex components in cutaneous vasoconstriction during skin cooling in humans. J Appl Physiol 100(6):2083–2088, 2006

    Article  PubMed  Google Scholar 

  2. Forst T, Caduff A, Talary M, Weder M, Brandle M, Kann P, Flacke F, Friedrich C, Pfutzner A: Impact of environmental temperature on skin thickness and microvascular blood flow in subjects with and without diabetes. Diabetes Technol Ther 8(1):94–101, 2006

    Article  CAS  PubMed  Google Scholar 

  3. Christen S, Delachaux A, Dischl B, Golay S, Liaudet L, Feihl F, Waeber B: Dose-dependent vasodilatory effects of acetylcholine and local warming on skin microcirculation. J Cardiovasc Pharmacol 44(6):659–664, 2004

    Article  CAS  PubMed  Google Scholar 

  4. Arildsson M, Nilsson GE, Stromberg T: Effects on skin blood flow by provocation during local analgesia. Microvasc Res 59(1):122–130, 2000

    Article  CAS  PubMed  Google Scholar 

  5. Thomson JG, Kerrigan CL: Hydrogen clearance: assessment of technique for measurement of skin-flap blood flow in pigs. Plast Reconstr Surg 88(4):657–663, 1991

    Article  CAS  PubMed  Google Scholar 

  6. Irwin MS, Thorniley MS, Dore CJ, Green CJ: Near infra-red spectroscopy: a non-invasive monitor of perfusion and oxygenation within the microcirculation of limbs and flaps. Br J Plast Surg 48(1):14–22, 1995

    Article  CAS  PubMed  Google Scholar 

  7. Wolff KD, Kolberg A, Mansmann U: Cutaneous hemoglobin oxygenation of different free flap donor sites. Plast Reconstr Surg 102(5):1537–1543, 1998

    Article  CAS  PubMed  Google Scholar 

  8. Strauss JM, Neukam FW, Krohn S, Schmelzeisen R, Borchard F: Postoperative monitoring of microvascular flap repair with pulse oximetry—initial experience. Handchir Mikrochir Plast Chir 26(2):80–83, 1994

    CAS  PubMed  Google Scholar 

  9. Franiel T, Schmidt S, Klingebiel R: First-degree burns on MRI due to nonferrous tattoos. AJR Am J Roentgenol 187(5):W556, 2006

    Article  PubMed  Google Scholar 

  10. Langer S, Sinitsina I, Biberthaler P, Krombach F, Messmer K: Revascularization of transplanted adipose tissue: a study in the dorsal skinfold chamber of hamsters. Ann Plast Surg 48(1):53–59, 2002

    Article  PubMed  Google Scholar 

  11. Gonzalez S, Gonzalez E, White WM, Rajadhyaksha M, Anderson RR: Allergic contact dermatitis: correlation of in vivo confocal imaging to routine histology. J Am Acad Dermatol 40(5 Pt 1):708–713, 1999

    Article  CAS  PubMed  Google Scholar 

  12. Rajadhyaksha M, Gonzalez S, Zavislan JM, Anderson RR, Webb RH: In vivo confocal scanning laser microscopy of human skin II: advances in instrumentation and comparison with histology. J Invest Dermatol 113(3):293–303, 1999

    Article  CAS  PubMed  Google Scholar 

  13. Pellacani G, Cesinaro AM, Seidenari S: In vivo confocal reflectance microscopy for the characterization of melanocytic nests and correlation with dermoscopy and histology. Br J Dermatol 152(2):384–386, 2005

    Article  CAS  PubMed  Google Scholar 

  14. Gerger SKA, Kern T, Massone C, Steiger K, Richtig E, Kerl H, Smolle J: Konfokale in vivo-Laserscanmikroskopie in der Melanomdiagnostik. Akt Dermatol; 30 (Jahrestagung der Arbeitsgemeinschaft Dermatologische Forschung, München, 21.–23. 10. 2004), 2004

  15. Agero AL, Busam KJ, Benvenuto-Andrade C, Scope A, Gill M, Marghoob AA, Gonzalez S, Halpern AC: Reflectance confocal microscopy of pigmented basal cell carcinoma. J Am Acad Dermatol 54(4):638–643, 2006

    Article  PubMed  Google Scholar 

  16. Gambichler T, Sauermann K, Altintas MA, Altmeyer P, Hoffmann K: Acute effect of solar-simulated radiation on epidermal thickness assessed by confocal laser scanning microscopy in vivo. J Eur Acad Dermatol Venereol 18(5):638–639, 2004

    Article  CAS  PubMed  Google Scholar 

  17. Gambichler T, Sauermann K, Altintas MA, Paech V, Kreuter A, Altmeyer P, Hoffmann K: Effects of repeated sunbed exposures on the human skin. In vivo measurements with confocal microscopy. Photodermatol Photoimmunol Photomed 20(1):27–32, 2004

    Article  CAS  PubMed  Google Scholar 

  18. Gonzalez S, Tannous Z: Real-time, in vivo confocal reflectance microscopy of basal cell carcinoma. J Am Acad Dermatol 47(6):869–874, 2002

    Article  PubMed  Google Scholar 

  19. Altintas MA, Altintas AA, Guggenheim M: In vivo evaluation of histomorphological alterations in first degree burn injuries by means of confocal-laser-scanning microscopy—more than “virtual histology”. J Burn Care Res 30:315–320, 2009

    Article  PubMed  Google Scholar 

  20. Altintas MA, Altintas AA, Guggenheim M: Differentiation of superficial-partial vs. deep-partial thickness burn injuries in vivo by confocal-laser-scanning microscopy. Burns 35:80–86, 2009

    Article  CAS  PubMed  Google Scholar 

  21. Sauermann K, Gambichler T, Wilmert M, Rotterdam S, Stucker M, Altmeyer P, Hoffmann K: Investigation of basal cell carcinoma [correction of carcionoma] by confocal laser scanning microscopy in vivo. Skin Res Technol 8(3):141–147, 2002

    Article  CAS  PubMed  Google Scholar 

  22. Yue K, Zhang X, Zuo YY: Noninvasive method for simultaneously measuring the thermophysical properties and blood perfusion in cylindrically shaped living tissues. Cell Biochem Biophys 50(1):41–51, 2008

    Article  CAS  PubMed  Google Scholar 

  23. Thompson-Torgerson CS, Holowatz LA, Flavahan NA, Kenney WL: Cold-induced cutaneous vasoconstriction is mediated by Rho kinase in vivo in human skin. Am J Physiol Heart Circ Physiol 292(4):H1700–H1705, 2007

    Article  CAS  PubMed  Google Scholar 

  24. Kellogg Jr., DL, Liu Y, Kosiba IF, O’Donnell D: Role of nitric oxide in the vascular effects of local warming of the skin in humans. J Appl Physiol 86(4):1185–1190, 1999

    CAS  PubMed  Google Scholar 

  25. Johnson JM, Yen TC, Zhao K, Kosiba WA: Sympathetic, sensory, and nonneuronal contributions to the cutaneous vasoconstrictor response to local cooling. Am J Physiol Heart Circ Physiol 288(4):H1573–H1579, 2005

    Article  CAS  PubMed  Google Scholar 

  26. Weiss T, Windthorst C, Weiss C, Kreuzer J, Bommer J, Kubler W: Acute effects of haemodialysis on cutaneous microcirculation in patients with peripheral arterial occlusive disease. Nephrol Dial Transplant 13(9):2317–2321, 1998

    Article  CAS  PubMed  Google Scholar 

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There are no funding sources for this study.

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All authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence this work.

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Authors and Affiliations

  1. Department of Plastic, Hand and Reconstructive Surgery, Medical School Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Mehmet Ali Altintas, A. E. Steiert, M. C. Aust, A. D. Niederbichler, C. Herold & P. M. Vogt

  2. Department of Plastic and Reconstructive Surgery, Cologne-Merheim University of Witten-Herdecke, Cologne, Germany

    A. A. Altintas

  3. Division of Plastic and Reconstructive Surgery, Burn Centre, Department of Surgery, University Hospital Zurich, Zurich, Switzerland

    M. Guggenheim

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  1. Mehmet Ali Altintas
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  2. A. A. Altintas
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  3. M. Guggenheim
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  4. A. E. Steiert
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  5. M. C. Aust
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  6. A. D. Niederbichler
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  7. C. Herold
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Correspondence to Mehmet Ali Altintas.

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Altintas, M.A., Altintas, A.A., Guggenheim, M. et al. Insight in Human Skin Microcirculation Using In Vivo Reflectance-Mode Confocal Laser Scanning Microscopy. J Digit Imaging 23, 475–481 (2010). https://doi.org/10.1007/s10278-009-9219-3

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  • DOI: https://doi.org/10.1007/s10278-009-9219-3

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