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Atopic Dermatitis & Contact Dermatitis

VivoSight can image and measure changes to the skin seen in Atopic Dermatitis and other inflammatory conditions

VivoSight Dynamic OCT has proven value for research into the differential diagnosis and monitoring treatments of inflammatory skin disease:

  • Quantification and monitoring of inflammatory disease severity
  • Detecting and measuring subclinical disease effects
  • Quantification of pharmaceutical treatment effects on Atopic Dermatitis (AD)
  • Accurate, rapid in-vivo measurement of contact dermatitis patch tests
Superficial Vascular Plexus Depth
Depth of the Superficial Vascular Plexus (SVP) at the capital fossa appears to increase with AD severity and may serve as a robust biomarker [11
Superficial Vascular Plexus Aid
Location determination and morphology assessment of the superficial vascular plexus aid in the management of AD.

Quantification and Monitoring

Overcome subjectivity with objective OCT measurements

  • Objective measurement of skin response informs therapeutic impact
  • Subjective assessment does not pick up subclinical disease
  • Visual scoring is observer dependent and relatively insensitive
VivoSight Dx detects, measures and analyzes AD related skin changes, such as:
  • Epidermal remodeling and thickness measurement
  • Inflammation and hidden abnormalities, as measured by alterations in vascular morphology, density and blood flow
  • Optical attenuation, as a proxy for collagen density Skin surface roughness

AD severity is characterized by increased epidermal thickness and hypertrophy

Structural OCT Healthy
OCT image of healthy individual with no history of AD
Structural OCT Uninvolved
OCT image captured from an uninvolved site on an eczema patient, showing slightly extended rete-pegs and an undulating DEJ
Structural OCT Uninvolved
OCT image captured from an involved site on a different eczema patient, showing what appears to be inflammatory acanthosis (Long thin epidermal papillae/rete-pegs)

Vascular Alterations

Vascular Alterations Depth of the Superficial Vascular Plexus (SVP) appears to increase with AD severity and may serve as a proxy for epidermal thickness [1].

The SVP depth may represent a robust biomarker for quantifying the severity of clinical and subclinical AD, as epidermal thickness may be difficult to measure directly in severe AD cases due to a not well demarcated dermo-epidermal junction (DEJ).

  • A selection of 2D angiographic OCT images of the cubital fossa illustrates correlation by showing significant differences in detected superficial vascular plexus (SVP) depth for different EASI scores, and further showing morphological differences [1]
Vascular Alterations SVP Depth 157
Healthy subject
Vascular Alterations SVP Depth 198
Patient unaffected area Local EASI = 0
Vascular Alterations SVP Depth 222
Patient with mild AD. 0 < Local EASI <5
Vascular Alterations SVP Depth 251
Patient with severe AD. Local EASI <5

Measurement and management of Sub-clinical AD

Detecting subclinical disease may lead to better control of treatment regime
  • Unlike existing subjective clinical assessment, VivoSight Dynamic OCT can measure subclinical changes to the skin
  • These subclinical changes may provide early indication of a disease flare up, and of response to treatment
  • This capability offers potential for improved control of Atopic Dermatitis and other inflammatory conditions using novel treatment strategies with proactive, earlier and less aggressive therapy regimes [1]
Sub-clinical AD patient
The Superficial Vascular Plexus (SVP) depth has the potential to check patients for severity and time-course of sub-clinical AD

Better Control of Flares through Monitoring with dynamic OCT

Visualise and quantify subclinical AD for advanced, proactive management

Chart descriptively showing phases of Atopic Dermatitis and potential measurement of subclinical inflammation with VivoSight DX D-OCT imaging

Quantification of Pharmaceutical Treatment Effects on AD

Shorten timelines of pharmaceutical research

  • Recently, a correlation between clinical improvement of AD and dynamic OCT imaging metrics has been demonstrated on patients undergoing a systemic therapy [2]
  • OCT biomarkers quantify pharmaceutical treatment effects to more efficiently accelerate drug development cycles
Pharmaceutic Scientist performing lab work

Significant OCT metrics for pharmaceutical treatment effects:

  • In-vivo measurement of vessel density, diameter and plexus depth
  • Epidermal thickness
  • Collagen density
VivoSight D-OCT images of Vessels of patients with severe Atopic Dermatitis before and after dupilumab treatment.
Vascular depth and density of patient with severe Atopic Dermatitis before and after dupilumab treatment.
Graphic representation of changing OCT metrics representing treatment effect of dupilumab. For illustration purposes only.
Graphic representation of changing OCT metrics representing treatment effect of dupilumab. For illustration purposes only.
Graphic representation of changing OCT metrics representing treatment effect of dupilumab. For illustration purposes only.

Use of OCT for Patch Test Grading and Evaluation of Allergic Contact Dermatitis (ACD)

  • Overcome subjectivity of patch test grading
  • More effectively distinguish between allergic and irritant contact dermatitis
  • Correlate OCT morphological and objective measures with type and severity of patch test reactions [3]

OCT detects clear-cut features and measures for the distinction between healthy skin, allergic and contact dermatitis (see table below) [3]

Clinical Image of persons back with Allergy Patch Tests
VivoSight OCT image of Microvesicles
Microvesicles (< 0.1 mm)
VivoSight Dx OCT image of Macrovesicles
Macrovesicles (> 0.1 mm)
VivoSight OCT image of large Vesicles
Coalescing vesicles
VivoSight Dx OCT Image of skin with thickened epidermis
Epidermal thickness
VivoSight Dx Dynamic OCT (D-OCT) image of Cutaneous blood flow (enface image)
Cutaneous blood flow
Graph of VivoSight OCT intensity vs depth in skin
Attenuation coefficient (AC)

VivoSight OCT can be helpful for a more objective evaluation, especially in weak or unclear reactions. An opportunity exists to develop a standardized algorithm for OCT-aided patch test grading [3]:

Table of OCT image features of Contact Dermatitis
In case of unclear lesions, an OCT scan is undertaken and the primary OCT measures in the green shaded area inform on the likely type of contact dermatitis, whereas the features in the yellow shaded area inform on the severity of Allergic Contact Dermatitis

1. Byers RA, Maiti R, Danby SG, Pang EJ, Mitchell B, Carre MJ, Lewis R, Cork MJ, Matcher SJ. Sub-clinical assessment of atopic dermatitis severity using angiographic optical coherence tomography. Biomedical Optics Express (BOE), Vol. 9, No. 4, 1 Apr 2018.

2. Manfredini M, Liberati S, Ciardo S, et al. Microscopic and functional changes observed with dynamic optical coherence tomography for severe refractory atopic dermatitis treated with dupilumab. Skin Res Technol. 2020;00:1–9.

3. Ruini, C, Rahimi, F, Fiocco, Z, et al. Optical coherence tomography for patch test grading: A prospective study on its use for noninvasive diagnosis of allergic contact dermatitis. Contact Dermatitis. 2020; 1– 9.

4. Rajabi‐Estarabadi, A., Vasquez‐Herrera, N., Martinez‐Velasco, M., Tsatalis, J., Verne, S., Nouri, K. and Tosti, A. (2020), Optical coherence tomography in diagnosis of inflammatory scalp disorders. J Eur Acad Dermatol Venereol, 34: 2147-2151. doi:10.1111/jdv.16304

5. Bieber T. Atopic Dermatitis. Ann Dermatol. 2010 May;22(2):125-137.

6. Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020 Aug 1;396(10247):345-360. doi: 10.1016/S0140-6736(20)31286-1. Erratum in: Lancet. 2020 Sep 12;396(10253):758. PMID: 32738956.

7. Conti A, Ciardo S, Mandel VD, Bigi L, Pellacani G. Speckled variance optical coherence tomography for the assessment of nail involvement in acrodermatitis continua of Hallopeau: A case study. Journal of International Medical Research 2016, Vol. 44(1S) 119–123


Explore the research and clinical applications for VivoSight

Advance Your Research and Development Programs

VivoSight Dx in combination with VivoTools image analysis software visualizes and quantifies treatment effects.

See the Whole Picture to Improve Outcomes

VivoSight Dx produces high resolution imaging of skin sub-structures and vascular networks to aid in patient care