Gislaine Vieira-Damiani1, Denise Lage2, Patrícia Érica Christofoletti Daldon2, Caroline Romanelli Tibúrcio Alves2, Maria Letícia Cintra3, Konradin Metze1, Javier Adur4, Vitor B Pelegati4, Hernandes F Carvalho5, Carlos Lenz Cesar6. 1. Department of Pathology, Medical School, University of Campinas, Campinas, Brazil. 2. Department of Dermatology, Celso Pierro Hospital, Pontifical Catholic University of Campinas, Campinas, Brazil. 3. Department of Pathology, Medical School, University of Campinas, Campinas, Brazil. Electronic address: marialet@fcm.unicamp.br. 4. Biophotonics Group, Department of Quantum Electronics, Institute of Physics Gleb Wataghin, University of Campinas, Campinas, Brazil. 5. Biophotonics Group, Department of Quantum Electronics, Institute of Physics Gleb Wataghin, University of Campinas, Campinas, Brazil; National Institute of Science and Technology on Photonics Applied to Cell Biology, University of Campinas, Campinas, Brazil; Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, Brazil. 6. Biophotonics Group, Department of Quantum Electronics, Institute of Physics Gleb Wataghin, University of Campinas, Campinas, Brazil; National Institute of Science and Technology on Photonics Applied to Cell Biology, University of Campinas, Campinas, Brazil; Department of Physics, Federal University of Ceara, Fortaleza, Brazil.
Abstract
BACKGROUND: The diagnosis of idiopathic atrophoderma of Pasini and Pierini (IAPP) relies on typical clinical features, particularly distinctive pigmented ovular/round depressed plaques. Histologic examination often reveals no obvious changes, but patterns of collagen distribution, using multiphoton imaging and second harmonic generation can help track hidden details of tissue organization contributing to atrophy. OBJECTIVE: To identify histologic features that distinguish IAPP from unaffected skin. METHODS: Eleven patients were included for conventional analyses. Masson trichrome- and Unna-Tanzer orcein-stained sections were evaluated using automated morphometry. Hematoxylin-eosin-stained sections were analyzed by multiphoton imaging using 2-photon excited fluorescence and second harmonic generation. RESULTS: No abnormalities were found under light microscopy or by automated quantification. Multiphoton imaging revealed no difference in optical density of either collagen or elastic fibers in lesioned and unaffected skin; however, horizontal collagen fiber organization in lesion specimens increased toward the lower dermis, whereas elastic fibers featured greater disorganization within the upper dermis. LIMITATIONS: The low number of patients evaluated. CONCLUSION: The atrophic appearance of IAPP lesions reflects changes in organization, but not in collagen and elastic tissue content. Minute organizational differences that are imperceptible to the experienced pathologist and undetectable by automated analyses were revealed by multiphoton analyses, particularly second harmonic generation, in association with texture analyses.
BACKGROUND: The diagnosis of idiopathic atrophoderma of Pasini and Pierini (IAPP) relies on typical clinical features, particularly distinctive pigmented ovular/round depressed plaques. Histologic examination often reveals no obvious changes, but patterns of collagen distribution, using multiphoton imaging and second harmonic generation can help track hidden details of tissue organization contributing to atrophy. OBJECTIVE: To identify histologic features that distinguish IAPP from unaffected skin. METHODS: Eleven patients were included for conventional analyses. Masson trichrome- and Unna-Tanzer orcein-stained sections were evaluated using automated morphometry. Hematoxylin-eosin-stained sections were analyzed by multiphoton imaging using 2-photon excited fluorescence and second harmonic generation. RESULTS: No abnormalities were found under light microscopy or by automated quantification. Multiphoton imaging revealed no difference in optical density of either collagen or elastic fibers in lesioned and unaffected skin; however, horizontal collagen fiber organization in lesion specimens increased toward the lower dermis, whereas elastic fibers featured greater disorganization within the upper dermis. LIMITATIONS: The low number of patients evaluated. CONCLUSION: The atrophic appearance of IAPP lesions reflects changes in organization, but not in collagen and elastic tissue content. Minute organizational differences that are imperceptible to the experienced pathologist and undetectable by automated analyses were revealed by multiphoton analyses, particularly second harmonic generation, in association with texture analyses.
Authors: Elisa de Oliveira Barcaui; Antonio Carlos Pires Carvalho; Juan Piñeiro-Maceira; Carlos Baptista Barcaui Journal: An Bras Dermatol Date: 2019-10-17 Impact factor: 1.896