Did you know there is an image system to monitor Cutaneous Lymphoma?

Westmead Dermatology is working to develop a better way to follow up patients with lymphomas of the skin.
Cutaneous Lymphomas (CTCL, Mycosis Fungoides) are rare skin cancers with a variable clinical presentation including patches, plaques and nodules on the skin that mimics common diseases such as eczema and psoriasis. Cutaneous lymphomas are diagnosed and monitored using multiple skin biopsies. As biopsies are invasive, painful and leave scars, we are testing an image technique to reduce the need for biopsies.
So far, this tool is being used for the diagnosis of melanoma, to help to define margins for surgery, and to check the therapeutic response after topical treatment of radiotherapy.
Are you curious about this technology?
This technology is called Reflectance Confocal Microscopy (RCM). It is a laser that in low frequency, transforms energy into images. The images are black and white and show details at cellular level, in other words, it is a life biopsy. We can observe the surface of the skin (epidermis and papillary dermis) and its architecture, dinamically. Moreover, this image system allows us to see the skin horizontally at multiple levels, creating a stack of images that can be transformed in a 3D model. And all this is happening with no pain and no side effects.
So far, our research team is working to correlate the RCM features to histopathology findings. The next step will be to use the RCM as a guide to perform biopsies more precisely. One previous study showed that when the RCM detects a vesicle-like structures (called Pautrier microabscess), it increases the accuracy of the biopsy.

In clinical practice, this innovative imaging technique is likely to extend to other skin diseases, not only during the initial clinical assessment but also while monitoring patients and evaluating their response to treatments.
Written by Bruna Melhoranse Gouveia