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Skin Vasculature & Blood Flow

VivoSight Dx produces and characterizes vascular network images

Understanding cutaneous vascular presentations is a prerequisite for effective research programs including:

  • Clinical research involving systemic and topical medications
  • Optimization of treatment parameters for lasers, energy devices etc.
Dramatic inflammatory reaction after topical exposure of skin to capsaicin. Left: vascular pattern of medial aspect of forearm of middle-age male. Right: adjacent site at same depth after exposure to capsaicin from Habanero pepper
Quantify treatment effects by measuring vessel density before and after treatment

Besides imaging vascular networks, VivoSight Dx and VivoTools measure the following vascular properties:

  • Vessel density by depth
  • Depth of the superficial vascular plexus
  • Modal vessel diameter of the superficial plexus
  • Density of vessels at the plexus level

VivoSight Dx Measurements Can Enhance Research of Inflammatory and Vascular Conditions:

Psoriasis

In addition to marked morphologic differences (thickened and bright stratum corneum, acanthosis), the number of blood vessels and vascular density is increased in psoriasis. Images courtesy of Welzel [3].

Psoriasis (top) compared to healthy adjacent skin (bottom). Especially in the upper stratum papillare, loops of dilated capillaries are present (arrows) [3]
Images courtesy of Themstrup [5]

Rosacea Therapy (Brimonidine)

Dynamic OCT en-face view of normal skin located on the cheek before (left) and 60 minutes after topical brimonidine.

Images shows a reduced number of vessels after application, however many of the medium to large vessels are still visible (right). Yellow bars indicate the location where measurements of vessel diameter were performed. The measurements showed a reduced vessel diameter of 42% after the application of brimonidine (diameter at baseline: 0.08 mm; diameter after brimonidine application: 0.046 mm).

Port Wine Stain Birthmarks and Rosacea

VivoSight Dx uncovers a wide variability of quantified vascular morphology requiring different, individual treatment approaches with lasers and energy device.

VivoSight Scans Show Highly Variable Architecture for a Variety of Vascular Lesions

En-face dynamic OCT scans of five port wine birthmarks, five hemangiomas, and two from normal skin. Images courtesy of Waibel [1]
Histograms of vessel diameters at three selected depths in a hemangioma. From this data it is possible to estimate both the cross-sectional area and the volume of vessels of a particular diameter range and depth range that is to be treated by laser.
References:

1. Schuh S., Welzel J. (2020) OCT-Guided Laser Treatment and Surgery. In: Bard R. (eds) Image Guided Dermatologic Treatments. Springer, Cham

2. Ulrich M, Braunmuehl T, Kurzen H, Dirschka T, Kellner C, Sattler EC, Berking C, Welzel J, Reinhold U. The sensitivity and specificity of optical coherence tomography for the assisted diagnosis of nonpigmented basal cell carcinoma: an observational study. Br J Dermatol. 2015;173(2):428–35.

3. Markowitz O, Schwartz M, Feldman E, Bienenfeld A, Bieber AK, Ellis J, Alapati U, Lebwohl MG, Siegel DM. Evaluation of optical coherence tomography as a means of identifying earlier stage basal cell carcinomas while reducing the use of diagnostic biopsy. J Clin Aesthet Dermatol. 2015;8(10):14–20.

4. Themstrup L, De Carvalho N, Nielsen SM, Olsen J, Ciardo S, Schuh S, Nørnberg BM, Welzel J, Ulrich M, Pellacani G, Jemec GBE. In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography. Exp Dermatol. 2018;27(2):156–65.

5. Ahluwalia J, Avram MM, Ortiz AE. Outcomes of Long-Pulsed 1064 nm Nd:YAG Laser Treatment of Basal Cell Carcinoma: A Retrospective Review. Lasers Surg Med. 2019 Jan;51(1):34-39

6. Ahluwalia J, Avram MM, Ortiz AE. The Evolving Story of Laser Therapeutics for Basal Cell Carcinoma. Dermatol Surg. 2020 Feb 11

7. Markowitz O, Psomadakis CE. Patient-driven management using same-day noninvasive diagnosis and complete laser treatment of basal cell carcinomas: a pilot study. Cutis. 2019 Dec;104(6):345-348;350;351

8. Markowitz O, Tongdee E, Levine A. Optimal cosmetic outcomes for basal cell carcinoma: a retrospective study of nonablative laser management. Cutis. 2019 May;103(5):292-297;E1;E2;E3.

9. C. A. Banzhaf, L. Themstrup, H. C. Ring, M. Mogensen and G. B. E. Jemec. Optical coherence tomography imaging of non-melanoma skin cancer undergoing imiquimod therapy. Skin Research and Technology 2013; 0: 1–7

Applications

Explore the research and clinical applications for VivoSight

Advance Your Research and Development Programs

VivoSight Dx in combination with VivoTools image analysis software visualizes and quantifies treatment effects.

See the Whole Picture to Improve Outcomes

VivoSight Dx produces high resolution imaging and measurement of skin sub-structures and vascular networks to aid in patient care