Dermoscopy adds important information to the assessment of cutaneous melanoma, but the risk of progression is predicted by histologic parameters and therefore requires surgery and histopathologic preparation. Neo-vascularization is crucial for tumor progression and worsens prognosis. The aim of this study was the in vivo evaluation of blood vessel patterns in melanoma with dynamic optical coherence tomography (D-OCT) and the correlation with dermoscopic and histologic malignancy parameters for the risk assessment of melanoma. In D-OCT vessel patterns, shape, distribution and presence/type of branching of 49 melanomas were evaluated in vivo at three depths and correlated with the same patterns in dermoscopy and with histologic parameters after excision. In D-OCT, blood vessel density and atypical shapes (coils and serpiginous vessels) increased with higher tumor stage. The histologic parameters ulceration and Hmb45- and Ki67-positivity increased, whereas regression, inflammation and PD-L1-positivity decreased with risk. CD31, VEGF and Podoplanin correlated with D-OCT vasculature findings. B-RAF mutation status had no influence. Due to pigment overlay and the summation effect, the vessel evaluation in dermoscopy and D-OCT did not correlate well. In summary, atypical vessel patterns in melanoma correlate with histologic parameters for risk for metastases. Tumor vasculature can be noninvasively assessed using D-OCT before surgery.

The aim of this study was to investigate acute wound healing with dynamic optical coherence tomography (D‐OCT). From 22 patients with 23 split skin graft donor sites, vessels at four wound edges, the wound bed, and adjacent and unaffected skin of the contralateral leg were measured by D‐OCT at six time points from surgery to 4 weeks of healing. Changes in vessel orientation, density, diameter, morphology and pattern in horizontal, vertical and 3D images were analysed for wound healing and re‐epithelialization. At 300 μm depth, there were significant differences of blobs and serpiginous vessels between normal and wounded skin. The wound had significantly more vertically oriented vessels, a higher degree of branching, vessel density and diameter compared with healthy skin. 3D images showed increased angiogenesis from healthy skin towards the wound centre, significantly higher vessel density at the wound than at normal skin and the highest at the interface. During wound healing blobs, coils and serpiginous vessels occurred significantly more frequently in lesional than healthy skin. Vessel density was greatest at the beginning, decreased and then increased by 4 weeks post‐surgery. D‐OCT helps to evaluate acute wound healing by visualizing and quantifying blood vessel growth in addition to re‐epithelialization.

BackgroundChronic ulcers, especially venous leg ulcers, are a major burden on the healthcare system. To date there are only few non-invasive established procedures for evaluation of blood perfusion in wounds. Dynamic optical coherence tomography (D-OCT) provides images of the skin's superficial vascularisation.ObjectivesThis study aims to investigate if and how the D-OCT measurement of chronic wounds can provide new information about the vascularisation during the healing process.MethodsWe examined 16 venous ulcers over 16 weeks and evaluated the vessel morphology and density using D-OCT at the wound bed, borders, two centimetres adjacent to the wound und at non-ulcerated skin on the contralateral leg.ResultsIn D-OCT scans clumps were unique and the most common vessel type in the wound area of venous ulcers, whereas lines and serpiginous vessels were the most common in non-ulcerated skin. At the wound border mottle and cluster patterns occurred more frequently. Healthy skin showed a significant increase of mesh pattern. Vessel density significantly increased at the wound area compared to non-ulcerated skin. During the healing process the wound border showed the most vascular changes while only an increase in curves was observed in the wound centre. Non-healing wounds had fewer dots and blobs at the borders, fewer dots, coils, clumps, lines and serpiginous vessels at the centre and fewer dots in adjacent skin. Temperature analysis showed higher temperatures in non-ulcerated skin, followed by the wound margin and centre. Non-healing wounds showed the lowest temperatures in the wound centre.ConclusionsThese results highlight the non-invasive use of D-OCT for the examination and monitoring of wound healing in chronic venous ulcers. D-OCT imaging of blood vessels may offer the potential to detect disorders of wound healing at an early stage, differentiate ulcers of different genesis and to tailor more individualized, patient-oriented therapy.

To date, therapeutic responses in plaque psoriasis are evaluated with clinical scores. No objective examination has been established. A recently developed non-invasive imaging tool, line-field confocal optical coherence tomography (LC-OCT), enables the in vivo live imaging of skin changes in psoriasis under therapy. The aim of this study was to measure therapeutic response clinically and with LC-OCT, comparing the subjectively scored epidermal changes with an AI-supported analysis. This prospective, observational study included 12 patients with psoriasis starting a systemic treatment with IL-17 inhibitors (secukinumab, ixekizumab, and bimekizumab). LC-OCT and clinical assessment with a local psoriasis and severity index of the study plaque and a control area were performed before the initiation of therapy as well as after 4 and 12 weeks of treatment. A manual and AI-supported measurement of the thickness of epidermis, stratum corneum, and undulation of the dermo-epidermal junction was carried out. Acanthosis and hyperkeratosis showed a significant reduction under treatment. AI-supported calculations were compared to subjective measurements showing good reliability with high correlation. AI-supported analysis of vascular changes may serve as a prognostic and therapeutic response marker in the future.

Zusammenfassung: Hintergrund: Realistische Trainingsmodelle sind essenziell, um Ärztinnen und Ärzte in klinischen Prozeduren zu schulen. In dieser Studie wurde untersucht, ob ein kostengünstiges, selbst generiertes 3D‐gedrucktes Hautmodell Früchten und Schaumstoffmodellen beim Erlernen von Hautstanzen überlegen ist. Patienten und Methodik: In die Studie (10/2023–02/2025) wurden 148 Medizinstudierende einbezogen, die das 3D‐Hautmodell, hergestellt aus weichem Silikon mit einer Shore‐Härte von 10A, mit Früchten und Schaumstoff für das Training der Stanzbiopsie verglichen. Vorherige Kohorten trainierten ausschließlich mit Früchten und Schaumstoff. Zusätzlich beurteilten 28 Ärztinnen und Ärzte die Realitätsnähe des 3D‐Modells im Vergleich zu echter Haut. Praktische Fertigkeiten wurden in Objective Structured Clinical Examinations (OSCEs) erhoben. Rückmeldungen von Studierenden und Ärzten erfolgten über standardisierte Fragebögen. Zudem wurden ökonomische und ökologische Aspekte analysiert. Ergebnisse: Die Studierenden bewerteten das 3D‐Hautmodell hinsichtlich Realismus und Trainingsgeeignetheit signifikant besser als Früchte und Schaumstoff (jeweils p < 0,001). Die OSCE‐Ergebnisse zeigten eine vergleichbare Kompetenzentwicklung (p = 0,2005). Ärztinnen und Ärzte stuften das 3D‐Modell sowohl anatomisch als auch haptisch als realistischer ein als Schaumstoff und Früchte (jeweils p < 0,001). Schlussfolgerungen: Das 3D‐gedruckte Hautmodell ist ein überlegenes, kosteneffizientes Trainingsinstrument, das die Limitationen konventioneller Modelle überwindet, das Vertrauen der Lernenden stärkt und den Fertigkeitserwerb fördert. Obwohl die Herstellung ressourcenintensiv ist, machen Wiederverwendbarkeit und kostengünstige Materialien das Modell langfristig nachhaltig. Die anatomische Realitätsnähe steigert das Interesse an der Dermatologie und macht das Modell zu einer vielversprechenden Innovation in der medizinischen Ausbildung.

Background: In the 2019/2020 winter semester, the University of Augsburg’s Faculty of Medicine introduced a competence-oriented model degree program with a spiral curriculum integrating theory and practice. A key feature, the clinical longitudinal course, emphasizes practical skills such as skin examination. Existing training materials for punch biopsies, e.g., foam models and fruit, have proven insufficient. This project aimed to create a realistic, cost-effective, reusable three-dimensional (3D) skin model to improve the teaching of punch biopsy and suturing techniques. Methods: The 3D skin model was developed in a multistage process. It began with a 3D scan created via a handheld 3D scanner and refined in 3D modeling software. A fused deposition modeling (FDM) printer produced negative molds that were filled with silicone, resulting in a realistic model. After several iterations, a design was achieved that successfully simulated the tactile and functional aspects of punch biopsy and skin suturing. Student feedback was collected through an anonymous online questionnaire assessing perceived realism, usefulness for practicing punch biopsies and suturing, and impact on their confidence. Results: The silicone-based skin simulator debuted in the 2023–2024 winter semester’s ‘examination of the skin’ course. A total of 82 students participated in the course, of whom 58 completed the evaluation questionnaire. The students used the model to perform punch biopsies and suturing, reporting that its material properties allowed these procedures to be practiced under course conditions. With a low production cost (of 0.62 € per model) compared to commercial models, it is a cost-efficient alternative to previous materials. The students provided positive feedback, reporting increased confidence in performing these procedures on humans for the first time. Conclusions: The 3D training model is an important advancement in introducing 3D technologies in practical training, providing realistic, cost-effective practice for punch biopsy and suturing. Its successful integration into the curriculum highlights its potential for broader applications in medical education. The evaluation indicated that the model provided realistic skin properties and proved effective for practicing punch biopsies and suturing, thus addressing the limitations of traditional training materials.