Proposal for an in vivo histopathologic scoring system for skin aging by means of confocal microscopy

Skin Res Technol. 2013 Feb;19(1):e167-73. doi: 10.1111/j.1600-0846.2012.00623.x. Epub 2012 Jun 7.

Abstract

Background: Many instrumental devices have been testing in analysing and quantifying the skin aging signs. However, histopathology still remains the only methods that allow a microscopic assessment of the skin. However, a skin biopsy is not feasible in aesthetically critical areas such as the face. Recently, confocal microscopy has been discovered as a noninvasive tool with a nearly histologic resolution. Distinct morphologic confocal aspects on facial skin have been described and correlated with the histopathologic counterparts.

Objectives: In our study we aim to develop an easy to use confocal aging score to quantify the skin aging related signs.

Methods: A sample of facial skin of fifty volunteers has been subjected to confocal imaging. Combining the previously identified confocal features, three different semi-quantitative scores were calculated: - epidermal disarray score (irregular honeycombed pattern + epidermal thickness + furrow pattern); - epidermal hyperplasia score (mottled pigmentation + extent of polycyclic papillary + epidermal thickness; - collagen score (curled fibers, 2 for huddles of collagen, 1 for coarse collagen structures, and 0 for thin reticulated collagen)

Results: The epidermal disarray score showed a stable trend up to 65 years and a dramatic increase in the elderly subjects epidermal. Hyperplasia score was characterized by an ascending trend from younger subjects to middle age. The total collagen score showed a progressive trend with age with a different proportion of distinct collagen type.

Conclusions: RCM is a powerful, noninvasive technique that could permit to microscopically quantify the aging signs and to test cosmetic efficacy.

Publication types

  • Clinical Trial
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cosmetics
  • Dermis / pathology*
  • Epidermis / pathology*
  • Face / pathology
  • Female
  • Humans
  • Hyperplasia / pathology
  • Microscopy, Confocal / methods*
  • Microscopy, Confocal / standards*
  • Middle Aged
  • Reproducibility of Results
  • Skin Aging / pathology*
  • Young Adult

Substances

  • Cosmetics