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Combined computer assisted capillary microscopy and laser Doppler imaging used to assess redistribution changes in skin of erythromelalgic patients during treatment with misoprostol
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Erythromelalgia is a rare condition defined by red, hot and painful extremities. Warmth intensifies the discomfort while cold provides relief. The clinical picture is heterogeneous with respect to aetiology and severity. We have previously postulated arteriovenous shunting in the skin as a common pathogenetic mechanism. Defects in prostaglandin synthesis, metabolism or functional response have been implicated in the pathogenesis of erythromelalgia. In this pilot study we wanted to describe the skin microcirculation before and after misoprostol treatment, an oral PGE1 analogue.

A non-randomised, placebo-compared study investigating the effect of misoprostol on the skin microcirculation in patients with erythromelalgia using Laser Doppler Perfusion Imaging (LDPI) and Computer Assisted Capillary Microscopy (CACM).

EM was treated with placebo for six weeks followed by misoprostol for the next six weeks. Cutaneous microcirculation was evaluated as determined by the analysis of laser Doppler perfusion imager (global skin perfusion) and computer assisted capillary microscopy (capillary perfusion) before and after whole body heating at baseline, after placebo and misoprostol treatment.

There were a significant increase in skin temperature, global perfusion and reduction in capillary density in non-treated erythromelalgia patients. After misoprostol treatment the changes in the microcirculation are reduced.

The results are consistent with earlier findings of increased global perfusion and reduced capillary density during central body heating. The microcirculatory changes after misoprostol treatment indicate reduced arteriovenous shunting and increased nutritive perfusion.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-89592 (URN)oai:DiVA.org:liu-89592 (OAI)diva2:608394 (DiVA)
Available from2013-02-27 Created:2013-02-27 Last updated:2013-02-27
In thesis
1. Computer assisted video microscopy
Open this publication in new window or tab >>Computer assisted video microscopy : in characterization of capillary ensembles
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis focuses on evaluation and analysis of capillary microcirculatory changes in the skin, that can be improved and extended by computer assisted video microscopy. Capillary microscopy has been used extensively, both in clinical practice and research, to study different phenomena in the microvasculature of the skin, mainly in the nailfold of fingers and toes where a large portion of the capillary loop can be observed.

In the majority of the different skin regions, the nutritive capillary network approaches the skin surface perpendicularly and capillary microscopy in these sites reveals the apex of the capillary loop as a dark spot. The main approach in this work has been to study a large ensemble of capillary loops, in order to apply statistical and planar models whilst, at the same time, obtaining spatial parameters related to the capillary localization.

The statistical models of proximity are based on nearest neighbour methods and triangulation techniques. The main reason for introducing these models is because of their capability to characterize the heterogeneity of the capillary ensemble.

A computer assisted video microscopy system, that enables both capturing and evaluating of capillary bed images, was assembled and was, thereafter, successfully used in laboratory and clinical studies.

Publisher, range
Linköping: Linköpings universitet, 2000. 64 p.
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 648
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-29442 (URN)14788 (Local ID)91-7219-822-2 (ISBN)14788 (Archive number)14788 (OAI)
Public defence
2000-09-12, Berzeliussalen, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Available from2009-10-09 Created:2009-10-09 Last updated:2013-02-27

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