[en] Under specific light illumination, particularly ultraviolet (UV) and near-UV light stimulation, the skin produces both specular light reflectance and, possibly, specific fluorescent emission. These properties offer diagnostic clues and disclose some peculiar functions of the skin. A series of superficial infections (erythrasma, some tinea capitis types, tinea/pityriasis versicolor, dermatophytoses, etc.) and pilosebaceous follicles enriched in Propionibacterium spp show fluorescence. This latter characteristic is downgraded or lost while on some anti-acne treatments. A quenching effect of fluorescence is observed following the application of sunscreens. The (pre)neoplastic areas prepared for methylaminolevulinate photodynamic therapy (MAL-PDT) show reddish fluorescence following drug metabolisation producing porphyrins by the abnormal activated cells. Of note, when using a recording sensitive CCD camera instead of casual visual observation, skin fluorescence may be superimposed on the specular reflectance of the incident light. With the current technology, these situations are not distinguished with confidence. Any harsh and scaly lesion appears brighter following yellowish specular light reflectance. Stratum corneum samplings collected on clear self-adhesive discs or cyanoacrylate skin surface strippings are conveniently examined ex vivo, taking advantage of the same optical properties.
Disciplines :
Dermatology
Author, co-author :
Szepetiuk, Gregory
Pierard, Sébastien ; Université de Liège - ULiège > Dép. d'électric., électron. et informat. (Inst.Montefiore) > Télécommunications
Scott MA, Hopper C, Sahota A, et al. Fluorescence photodiagnosis and photobleaching studies of cancerous lesions using ratio imaging and spectroscopic techniques. Laser Med Sci 2000; 15: 63-72.
Liutkeviciute-Navickiene J, Mordas A, Rutkovskiene L, Bloznelyte-Plesniene L. Skin and mucosal fluorescence diagnosis with different light sources. Eur J Dermatol 2009; 19: 135-40.
Szepetiuk G, Piérard-Franchimont C, Quatresooz P, Piérard GE. How I explore... skin by photodiagnosis using skin fluorescence and its functional imaging. Rev Med Liège 2010; 65: 521-6.
Szepetiuk G, Piérard-Franchimont C, Paquet P, Piérard GE. Physiobiological foundation of skin fluorescence. Pathol Biol (in press).
Uhoda E, Piérard-Franchimont C, Petit L, Piérard GE. Skin weathering and ashiness in black Africans. Eur J Dermatol 2003; 13: 574-8.
Uhoda E, Petit L, Piérard-Franchimont C, Piérard GE. Ultraviolet light-enhanced visualization of cutaneous signs of carotene and vitamin A dietary deficiency. Acta Clin Belg 2004; 59: 97-101.
Quatresooz P, Xhauflaire-Uhoda E, Piérard-Franchimont C, Piérard GE. Epidermal field carcinogenesis in bald-headed. An attempt at finetuning early noninvasive detection. Oncol Rep 2009; 21: 1313-6.
Xhauflaire-Uhoda E, Piérard-Franchimont C, Piérard GE, Quatresooz P. Weathering of the hairless scalp: a study using skin capacitance imaging and ultraviolet light-enhanced visualization. Clin Exp Dermatol 2010; 35: 83-5.
Wennberg AM, Gudmundson F, Stenquist B, et al. In vivo detection of basal cell carcinoma using imaging spectroscopy. Acta Derm Venereol 1999; 79: 54-61.
Stefanidou M, Tosca A, Themelis G, Vazgiouraki E, Balas C. In vivo fluorescence kinetics and photodynamic therapy efficacy of d-aminolevulinic acid-induced porphyrins in basal cell carcinomas and actinic keratoses; implications for optimization of photodynamic therapy. Eur J Dermatol 2000; 10: 351-6.
Angell-Petersen E, Sorensen R, Warloe T, et al. Porphyrin formation in actinic keratosis and basal cell carcinoma after topical application of methyl 5-aminolevulinate. J Invest Dermatol 2006; 126: 265-71.
Fritsch C, Ruzicka T. Fluorescence diagnosis and photodynamic therapy in dermatology from experimental state to clinic standard methods. J Environ Pathol Toxicol Oncol 2006; 25: 425-40.
Juzeniene A, Peng Q, Moan J. Milestones in the development of photodynamic therapy and fluorescence diagnosis. Photochem Photobiol Sci 2007; 6: 1234-45.
Vereecken P, Da Costa CM, Steels E, De Lathouwer O, Heenen M, De Mey A. Fluorescence diagnosis of face-located basal cell carcinomas: a new dermatological procedure which may help the surgeon. Acta Chir Belg 2007; 107: 205-7.
Johnsson A, Kjeldstad B, Melo TB. Fluorescence from pilosebaceous follicles. Arch Dermatol Res 1987; 279: 190-3.
Tochio T, Tanaka H, Nakata S, Ikeno H. Accumulation of lipid peroxide in the content of comedones may be involved in the progression of comedogenesis and inflammatory changes in comedones. J Cosmet Dermatol 2009; 8: 152-8.
Schaller M, Loewenstein M, Borelli C, et al. Induction of a chemoattractive proinflammatory cytokine response after stimulation of keratinocytes with Propionibacterium acnes and coproporphyrin III. Br J Dermatol 2005; 153: 66-71.
Arakane K, Ryu A, Hayashi C, et al. Singlet oxygen (1Δg) generation from coproporphyrin in Propionibacterium acnes on irradiation. Biochem Biophys Res Comm 1996; 223: 578-82.
Son T, Han B, Jung B, Nelson JS. Fluorescent image analysis for evaluating the condition of facial sebaceous follicles. Skin Res Technol 2008; 14: 201-7.
Youn SW, Kim JH, Lee JE, Kim SO, Park KC. The facial red fluorescence of ultraviolet photography: is this color due to Propionibacterium acnes or the unknown content of secreted sebum?. Skin Res Technol 2009; 15: 230-6.
Pagnoni A, Kligman AM, Kollias N, Goldberg S, Stoudemayer T. Digital fluorescence photography can assess the suppressive effect of benzoyl peroxide on Propionibacterium acnes. J Am Acad Dermatol 1999; 41: 710-6.
Borelli C, Merk K, Schaller M, et al. In vivo porphyrin production by P. acnes in untreated acne patients and its modulation by acne treatment. Acta Derm Venereol 2006; 86: 316-9.
Angell-Petersen E, Christensen C, Müller CR, Warloe T. Phototoxic reaction and porphyrin fluorescence in skin after topical application of methyl aminolevulinate. Br J Dermatol 2007; 156: 301-7.
Quatresooz P, Piérard-Franchimont C, Paquet P, Piérard GE. Crossroads between actinic keratosis and squamous cell carcinoma, and novel pharmacological issues. Eur J Dermatol 2008; 18: 6-10.
De Berker D, McGregor JM, Hughes BR. Guidelines for the management of actinic keratoses. Br J Dermatol 2007; 156: 222-30.
Piérard GE, Basset-Seguin N, Hengge U, et al. Actinic keratosis under scrutiny-20 questions and answers. Bruxelles: Publ. Artoos, 2009, p. 1-63.
Cheong WF, Prahl SA, Welch AJ. A review of the optical properties of biological tissues. IEEE J Quantum Electron 1990; 26: 2166-85.
Martin A, Tope WD, Grevelink JM, et al. Lack of selectivity of protoporphyrin IX fluorescence for basal cell carcinoma after topical application of 5-aminolevulinic acid: implications for photodynamic treatment. Arch Dermatol Res 1995; 287: 665-74.
Piérard-Franchimont C, Arrese-Estrada J, Quatresooz P, Piérard GE. Cyanoacrylate skin surface strippings. In: Farage M, Miller KW, Maibach HI, editors. Textbook of aging skin. Heidelberg: Publ. Springer Science, 2010, p. 393-9.