A comparison between reflectance confocal microscopy and multiphoton microscopy for the in vivo study of the aging skin

Summary: Abstract Body: The purpose of our review article is to compare reflectance confocal microscopy (RCM) and multiphoton microscopy (MPM) for the in vivo study of the aging skin. Multiple databases including Google Scholar, PubMed and Clinical Key were searched and all pertinent articles since inception were included. Our study revealed that both RCM and MPM are revolutionary non-invasive imaging modalities for the in vivo study of the aging skin, each with its own unique set of strengths and weaknesses. RCM provides reasonably accurate information about skin aging while being relatively cost-effective (~100k). Its major limitations include low penetration depth (up to level of superficial dermis), inability to differentiate between collagen and elastin fibers and relative difficulty in interpretation of images due to absence of color staining. MPM is an excellent skin imaging modality that provides great detail about the skin at a considerable depth (up to level of deep dermis). Unlike RCM, not only does it provide colored images of the skin, it is also able to differentiate between elastin and collagen. This translates into increased ease of image interpretation and more accurate assessment of skin aging, respectively. Its major limitations are its cost (~500k) and small field of view which makes the image acquisition process time consuming. Future efforts should focus on improving the MPM commercial setups in the form of increasing efficiency (decreasing the image acquisition time) and reducing cost. Atika Malik¹, Noah Musolff², Madeline Tchack³, Babar Rao^{4, 2} 1. Internal Medicine, AdventHealth Orlando, Orlando, FL, United States. 2. Rao Dermatology, New York, NY, United States. 3. Rutgers The State University of New Jersey, New Brunswick, NJ, United States. 4. Dermatology, Cornell University, Ithaca, NY, United States. Bioinformatics, Computational Biology, and Imaging