Vulvar Lichen Sclerosus (VLS) is a chronically inflammatory disorder that requires early diagnosis and long-term follow-up for successful therapy and prevention of malignancy. In this paper, we propose multimodal optical coherence tomography (MM OCT) as a non-invasive diagnostic technique of early and advanced VLS. The MM OCT provides 3D real-time visualization of the vulvar skin structure with high spatial resolution, as well as label-free visualization of blood and lymphatic vessels. Normal vulvar skin according to MM OCT is characterized by a layered structure, with a clear boundary between epidermis and dermis. Dermis contains inclusions with a background signal corresponding to lymphatic vessels. A dense blood and lymph vessels networks are visualized by OCT angiography. Early VLS according to MM OCT is characterized by moderate epidermis thickness with a high signal intensity due to backscattering by the stratum corneum. Dermis has high OCT signal due to high backscattering structures such as thickened collagen fibers, dilated vessels and inflammatory cells. The dermal–epidermal junction is less contrasting. Decreased density of blood and lymph vessels is detected by OCT angiography. Primarily, subepidermal vessels disappear. Advanced VLS according to MM OCT is characterized by atrophic epidermis with a high signal intensity due to scattering by the stratum corneum. The dermal–epidermal junction is low contrast; the skin layered structure is disrupted. The dermis loses its usual structure due to the formation of pathognomonic for VLS areas of homogenization that does not backscatter the light and looks like areas with low OCT signal. Blood and lymph vessels are not visualized on OCT angiography. The ability of MM OCT to visualization structural skin changes in early and advanced stages of VLS has been demonstrated for the first time.

ESDR250 - Non-invasive diagnosis of early and advanced vulvar lichen sclerosus by multimodal optical coherence tomography

The scientific meeting of the European Society for Dermatological Research (ESDR) is held yearly, usually in September. With an international attendance of more than 1000 skin scientists from around the globe, the four-day event includes short oral presentations from peer-reviewed abstracts, keynote lectures from international experts, sponsored symposia, satellite programs, educational events as well as an important focus on posters, networking and building collaborations amongst scientists. For more information about this year’s meeting visit our website.