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How to Read OCT Images

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B-scan & Histopathology

・Stratum corneum (yellow arrow) ・Keratinocytes nuclei of OCT image is seen as dark oval (white arrow). ・Melanin in the OCT image presents as hyperreflective spots (red arrow). ・Blood vessel (yellow arrowhead) ・Papillary dermis (white arrowhead)

E-scan Stratum Corneum

The stratum corneum is shown as bright material and visible dark and linear skin furrows. ・Dense keratin ・Skin furrows – skin folds

E-scan Stratum Granulosum

The stratum granulosum is shown as honeycombed structures consists of large keratinocytes. At times, dark and linear skin furrows are visible. ・Dark oval nuclei of the keratinocyte with bright cytoplasm ・Skin furrows – skin folds

E-scan Stratum Spinosum

The stratum spinosum is shown as typical honeycombed structures consists of keratinocytes. ・Bright cytoplasm and dark oval-round nuclei of the keratinocyte ・Skin furrows – skin folds

E-scan Dermo-Epidermal Junction

The dermo-epidermal junction is shown as rimmed structures consists of bright keratinocytes surrounding the papillary dermis. ・Bright cytoplasm and dark oval-round nuclei of the keratinocyte ・Melanosomes-containing keratinocytes and melanocytes ・Papillary dermis

E-scan Papillary Dermis

The upper layer of the dermis. The loose areolar connective tissue consists of fine and loosely arranged collagen fibers. ・Collagen fibers

E-scan Reticular Dermis

The main portion of the dermis, including densely packed collagen fibers, elastic fibers, ground substance, and blood vessels ・Collagen fibers ・Blood vessel

Normal Skin

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The morphology and melanin intensity of facial skin varies with age and skin type. The aging process or sun damage affects the thickness, degree of flatness (loss of rete ridges), melanin pigmentation in the epidermis, and elastic fiber degeneration (solar elastosis) in the upper dermis.

The morphology and melanin intensity of facial skin varies with age and skin type. The aging process or sun damage affects the thickness, degree of flatness (loss of rete ridges), melanin pigmentation in the epidermis, and elastic fiber degeneration (solar elastosis) in the upper dermis.

The morphology and melanin intensity of facial skin varies with age and skin type. The aging process or sun damage affects the thickness, degree of flatness (loss of rete ridges), melanin pigmentation in the epidermis, and elastic fiber degeneration (solar elastosis) in the upper dermis.

The spiral shape of the acrosyringium in the epidermis is demonstrated clearly.

The palms and soles have the thickest stratum corneum in our body.

Skin Tumor

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Actinic Keratosis

Actinic keratosis is a pre-malignant skin neoplasm due to severe sun damage. The characteristic pathological features include the disoriented and disorganized atypical keratinocytes in the basal cell layer or lower epidermis, and prominent solar elastosis in the upper dermis.

Bowen's Disease

Bowen’s disease is a synonym for squamous cell carcinoma in situ. It’s featured by disorientedly arranged atypical keratinocytes in the whole layer of the epidermis. The epidermis is often acanthotic. The nuclei of keratinocytes in Bowen’s disease may be pleomorphic in size and shape and become crowded. The parakeratosis and solar elastosis are common but not necessarily present.

Basal Cell Carcinoma

Basal cell carcinoma is the most common skin malignancy. Pathologically, it presents with nodular proliferation of tumor lobules in the dermis and attached to the epidermis. The epidermis can be normal looking or ulcerated. Retraction space presents between tumor lobule and fibromyxoid stroma is a characteristic feature. The blood vessels in the peri-tumoral stroma are often ectatic.

Basal Cell Carcinoma

Basal cell carcinoma is the most common skin malignancy. Pathologically, it presents with nodular proliferation of tumor lobules in the dermis and attached to the epidermis. The epidermis can be normal looking or ulcerated. Retraction space presents between tumor lobule and fibromyxoid stroma is a characteristic feature. The blood vessels in the peri-tumoral stroma are often ectatic.

Basal Cell Carcinoma

Basal cell carcinoma is the most common skin malignancy. Pathologically, it presents with nodular proliferation of tumor lobules in the dermis and attached to the epidermis. The epidermis can be normal looking or ulcerated. Retraction space presents between tumor lobule and fibromyxoid stroma is a characteristic feature. The blood vessels in the peri-tumoral stroma are often ectatic.

Basal Cell Carcinoma

Basal cell carcinoma is the most common skin malignancy. Pathologically, it presents with nodular proliferation of tumor lobules in the dermis and attached to the epidermis. The epidermis can be normal looking or ulcerated. Retraction space presents between tumor lobule and fibromyxoid stroma is a characteristic feature. The blood vessels in the peri-tumoral stroma are often ectatic.

Inflammatory Skin Disease

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Spongiotic Dermatitis

Spongiotic dermatitis is a pathological diagnosis and often indicating eczematous dermatitis. Pathologically, eczematous dermatitis varies from acute, subacute, to chronic stage. In an acute stage, the stratum corneum and the thickness of the epidermis are relatively normal. It shows widened space between keratinocytes due to intercellular edema. The process is called spongiosis.

Subacute Eczema

In subacute eczematous dermatitis, the skin thickens and presents with scales. Pathologically, there are hyperkeratosis, parakeratosis, irregular acanthosis, and the presence of foci of spongiosis in the epidermis. The blood vessels in the dermis may be ectatic due to inflammation.

In chronic eczematous dermatitis, the skin becomes very thick. There are usually thick and compact stratum corneum and irregular acanthosis. The spongiosis may not be obvious in this stage.

Bullous Pemphigoid

Bullous pemphigoid is an autoimmune bullous disease featured by eruptive tense blisters on the skin. Pathologically, it shows subepidermal separation in the dermal-epidermal junction due to IgG antibody deposition in the basement membrane.

Lichen planus is a subacute to chronic idiopathic inflammatory skin disorder. It is featured by lichenoid interface dermatitis pathologically. The characteristic findings include compact hyperkeratosis, saw-toothed irregular acanthosis, blurred dermal-epidermal junction, and pigment incontinence in the upper dermis.

Psoriasis is a chronic inflammatory skin disease featured by eruptive well-demarcated reddish plaques covered with thick silver-white scales. Pathologically, it shows diffuse hyperkeratosis and parakeratosis and often has neutrophils aggregation in the parakeratosis. The epidermis is regularly acanthosis and dermal papillae may be dilated and close to the surface.

Aesthetic Medicine

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Melasma is a common skin pigment disorder. Pathologically, it usually shows increased melanin, Solar elastosis, and rete ridge flattening.

Melasma is a common skin pigment disorder. Pathologically, it usually shows increased melanin, Solar elastosis, and rete ridge flattening.

Demodex mites are commonly present in the skin rich in sebaceous glands, such as facial skin. Either B-scan or E-scan can highlight the presence of demodex mites in the hair follicle. Checking different levels of E-scan images is especially helpful to count the number of mites.

Demodex mites are commonly present in the skin rich in sebaceous glands, such as facial skin. Either B-scan or E-scan can highlight the presence of demodex mites in the hair follicle. Checking different levels of E-scan images is especially helpful to count the number of mites.

Large Cell Acanthoma

Large cell acanthoma is a transitional stage between solar lentigo and early seborrheic keratosis. The stratum corneum is more compact and mildly thickened. The cells, including cytoplasm and nuclei, are larger than the peripheral normal skin. The basal cell layer is usually hyperpigmented and may have mildly elongated rete ridges.

Lentigo Simplex

Lentigo simplex is the earliest stage to form a nevus. Pathologically, it usually shows mild proliferation of melanocytes at the basal cell layer without nest formation. It usually presents with basal hyperpigmentation. The excess melanin produced from those melanocytes can be demonstrated in the keratinocytes in the spinous layer.

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