Tanja Maier

Morphology of basal cell carcinoma in high definition optical coherence tomography: en-face and slice imaging mode, and comparison with histology.

Background  Optical coherence tomography (OCT) allows real‐time, in vivo examination of basal cell carcinoma (BCC). A new high definition OCT with high lateral and axial resolution in a horizontal (en‐face) and vertical (slice) imaging mode offers additional information in the diagnosis of BCC and may potentially replace invasive diagnostic biopsies.

Noninvasive in vivo detection and quantification of Demodex mites by confocal laser scanning microscopy

Summary Background  In many Demodex‐associated skin diseases Demodex mites are present in abundance and seem to be at least partially pathogenic. So far all diagnostic approaches such as scraping or standardized superficial skin biopsy are (semi‐)invasive and may cause discomfort to the patient.

Nestin and SOX9 and SOX10 transcription factors are coexpressed in melanoma

Please cite this paper as: Nestin and SOX9 and SOX10 transcription factors are coexpressed in melanoma. Experimental Dermatology 2010; 19: e89–e94.

SOX9 and SOX10 but Not BRN2 Are Required for Nestin Expression in Human Melanoma Cells

Nestin is an intermediate filament protein and a marker of neuroectodermal stem cells indicating multipotentiality and regenerative capability. In melanoma tissues, nestin re-expression was correlated with tumor progression. Activation of the nestin neural enhancer was shown to be dependent on the binding of class III POU transcription factors, with brain-2 (BRN2) suggested to play a key role. We found both nestin and BRN2 mRNA in almost all of 13 analyzed melanoma cell lines of different progression stages, but expression levels did not correlate. Nestin protein was detected in 11 of 13 and BRN2 protein in 7 of 13 melanoma cell lines independent of progression stage. Downregulation of BRN2 by small-interfering RNA did not alter nestin expression in melanoma cells. However, POU proteins, such as BRN2, commonly cooperate with transcription factors of the Sry-box (SOX) family by binding to a nearby DNA site necessary for their action. SOX9 and SOX10 have been shown to be expressed in melanocyte precursors, with SOX10 downregulated upon differentiation. We now demonstrate SOX9 and SOX10 protein expression in melanoma tissues and cell lines. Downregulation of SOX9 and of SOX10 markedly decreased nestin levels in melanoma cells in a cooperative manner. Thus, SOX9 and SOX10 but not BRN2 seem to be required for nestin expression in human melanoma.

Actinic keratosis in the en-face and slice imaging mode of high-definition optical coherence tomography and comparison with histology.

Background  Optical coherence tomography (OCT) allows real‐time, in vivo examination of nonmelanoma skin cancer. An innovative high‐definition (HD)‐OCT with a horizontal (en‐face) and vertical (slice) imaging mode offers additional information in the diagnosis of actinic keratosis (AK) and may potentially replace invasive diagnostic biopsies.

Accuracy of a smartphone application using fractal image analysis of pigmented moles compared to clinical diagnosis and histological result

Lately, various smartphone applications have been introduced as diagnostic self‐monitoring tools in the evaluation of pigmented moles, but most of these techniques have not been evaluated systematically.

Reflectance confocal microscopy in the diagnosis of partially and completely amelanotic melanoma: report on seven cases

Background  The clinical diagnosis of amelanotic melanoma is often challenging, because the classical clinical and dermoscopic features of pigmented melanoma are usually missing. The reflectance confocal microscopy (RCM) offers an additional possibility of an in vivo diagnosis of both pigmented and amelanotic melanoma lesions.

Ex vivo high-definition optical coherence tomography of basal cell carcinoma compared to frozen-section histology in micrographic surgery: a pilot study

Background  Micrographic surgery is an established, but time‐consuming operating procedure for facial basal cell carcinoma (BCC). A new high‐definition (HD) optical coherence tomography (OCT) with high lateral and axial resolution in a horizontal (en‐face) and vertical (slice) imaging mode allows a fast and non‐invasive in vivo examination of BCC.

Osteopontin and ‘Melanoma Inhibitory Activity’: Comparison of Two Serological Tumor Markers in Metastatic Uveal Melanoma Patients

Background: Evaluation of the protein osteopontin (OPN) as a potential new marker in comparison to melanoma inhibitory activity (MIA) for screening and detection of metastatic uveal melanoma. Methods: Plasma levels of 32 patients with uveal melanoma were analyzed for OPN and MIA by enzyme-linked immunosorbent assay (ELISA). Fourteen of these patients had clinically detectable liver metastases. Results: Median plasma concentration of OPN in patients with metastatic disease was 152.01 ng/ml compared to 47.39 ng/ml in patients without clinically detectable metastases (p < 0.001). The difference between the median MIA plasma levels in patients with (13.11 ng/ml) and patients without (5.64 ng/ml) metastatic disease was also statistically significant (p < 0.001). No correlation could be found between MIA or OPN levels and tumor height in patients without clinically detectable metastases. Conclusion: The proteins MIA and OPN seem to be promising tumor markers for the metastasis screening in patients with uveal melanoma.

Treatment monitoring of topical ingenol mebutate in actinic keratoses with the combination of optical coherence tomography and reflectance confocal microscopy: a case series

DEAR EDITOR, Ingenol mebutate gel has recently been approved for the topical treatment of actinic keratoses (AKs). Modern imaging techniques such as optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) have proved useful for the noninvasive diagnosis of nonmelanoma skin cancer. The techniques differ in optical resolution and penetration depth. The objective of our study was to define the morphological changes of AK under topical treatment with ingenol mebutate and to evaluate the treatment response by applying both OCT and RCM. The study was performed at the Department of Dermatology, University Hospital Munich, after obtaining written informed consent from each patient. We investigated 14 AK lesions in four patients (three female, one male) prior to topical application of ingenol mebutate. In a predefined treatment area of 25 cm on the upper extremities, two to four clinically evident AK lesions were marked and photographed. For noninvasive OCT imaging a Fourier-domain OCT system (Vivosight ; Michelson Diagnostics, Kent, U.K.) with a resolution of 5–7 5 lm and a penetration depth of 1 5–2 mm was used. The RCM instrument (Vivascope 1500; Mavig GmbH, Munich, Germany) had a resolution of around 1 lm and a penetration depth of 250 lm. Ingenol mebutate 500 lg g 1 gel (Picato ; LEO Pharma, Neu-Isenberg, Germany) was applied for two consecutive days by the treating physician (T.M.) as recommended. The local reaction was evaluated on day 3 and the therapeutic outcome between days 28 and 56 by clinical inspection, OCT and RCM. Partial response by clinical evaluation was defined as ≥ 75% clearance of the lesions. Partial response by OCT and RCM imaging was defined as the presence of at least one of the three typical AK criteria described below. The initial clinical evaluation of the 14 AKs (Table 1) showed typical features of AK with hyperkeratosis (seven), erythema (14) and scaling (11). OCT imaging showed previously described features of AK, namely crusts or scaling (eight), epidermal broadening (11) and ill-defined dermoepidermal boarders (10). RCM imaging showed features typical of AK, such as hyperkeratosis (11), broadened honeycomb pattern (14) and cellular pleomorphism (14). On day 3 of treatment the clinical reaction was erythema (10), vesiculation or pustulation (10) and erosion (four). At this time point subepidermal blistering and dermal oedema were evident by OCT, while swelling of keratinocytes could be visualized by RCM (Fig. 1). In OCT, vesiculation was found in 11 cases and dermal oedema in six. In RCM, vesiculation, swelling and detachment of keratinocytes was found in all 14 lesions. The therapeutic outcome was evaluated clinically as complete clearance in six cases and partial response in eight. OCT and RCM imaging showed complete clearance in five and four lesions, respectively,