[Possibilities of multiphoton microscopy for the diagnosis of the vulvar lichen sclerosus].

Autor: Radenska-Lopovok SG; I.M. Sechenov First Moscow State Medical University, Moscow, Russia., Potapov AL; Privolzhsky Research Medical University, Nizhny Novgorod, Russia., Loginova MM; Privolzhsky Research Medical University, Nizhny Novgorod, Russia.; Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia., Elagin VV; Privolzhsky Research Medical University, Nizhny Novgorod, Russia., Bychkova AE; National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov, Moscow, Russia., Karabut MM; Privolzhsky Research Medical University, Nizhny Novgorod, Russia., Kuznetsov SS; N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Nizhny Novgorod, Russia., Asaturova AV; National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov, Moscow, Russia., Kuznetsova IA; Privolzhsky Research Medical University, Nizhny Novgorod, Russia.; N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Nizhny Novgorod, Russia., Apolikhina IA; National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov, Moscow, Russia., Gladkova ND; Privolzhsky Research Medical University, Nizhny Novgorod, Russia., Sirotkina MA; Privolzhsky Research Medical University, Nizhny Novgorod, Russia.
Jazyk: ruština
Zdroj: Arkhiv patologii [Arkh Patol] 2023; Vol. 85 (3), pp. 29-39.
DOI: 10.17116/patol20238503129
Abstrakt: Background: Vulvar lichen sclerosus (VLS) is a chronic and recurrent dermatosis of an inflammatory nature with severe focal atrophy of the skin. Connective tissue changes are polymorphic and are still not taken into account in histological diagnostics due to the difficulty of interpreting routine histological methods. In this work, we use multiphoton microscopy (MPM) as a new imaging technique that provides detailed information about the organization of collagen fibers in the dermis based on a non-linear second harmonic generation (SHG) process.
Objective: To determine the degree of connective tissue damage in lichen sclerosus using standard histological techniques and to reveal the diagnostic capabilities of multiphoton microscopy.
Material and Methods: We studied 42 biopsies with a histopathological diagnosis of VLS and 10 biopsies of normal vulvar skin. Histological, histochemical and immunohistochemical evaluation was used in comparison with MPM data. Quantitative analysis included the determination of the thickness, length of collagen fibers and the average intensity of the SHG signal.
Results: A comprehensive study of the skin showed 4 groups of changes that can be regarded as the degree of the dermis damage: initial, mild, moderate, severe. The affected area at the initial and mild degree has subtle changes, however, it is reliably identified by quantitative analysis of the SHG signal. So, the initial degree is characterized by thin (1.3-1.8 µm) long (56-69 µm) collagen fibers, with a moderate degree, the fibers are thickened (3.4-4.3 µm) and fragmented (22-37 µm). The affected area in moderate and severe cases undergoes homogenization, which is associated with the deposition of extremely thin (0.6-0.9 μm) short (16-28 μm) collagen fibers and the expression of type V collagen.
Conclusion: Multiphoton microscopy in the second harmonic generation mode is a reliable method for identifying collagen fibers in tissues. The study made it possible to identify 4 degrees of the dermis damage in vulvar lichen sclerosus.
Databáze: MEDLINE