Noninvasive assessment of morphological and vascular features of the normal vulvar skin using multimodal OCT

The vulva is a specific topographic region of the skin with complex morphology and a variety of functions. The combination of the urinary, reproductive and gastrointestinal systems in the same area makes the vulva susceptible to a wide range of diseases that require a multidisciplinary approach. As a result of these anatomical and physiological features, vulvar diseases are difficult to diagnose and insufficiently recognized. Multimodal optical coherence tomography (MM OCT) is an optical tool that allows real-time assessment of the structure of vulvar tissues with a resolution of 10-15 mu m, and also provides label-free visualization of blood and lymphatic vessels. The advantages of the MM OCT method are its non-invasiveness, the possibility of examining a large tissue area, as well as obtaining data from various parts of the organ under study. In this paper, we use cross-polarization OCT, angiography, and lymphangiography with parallel histological examination to describe the structure of normal hairless vulvar skin. Two variants of the structure of vulvar skin were identified: skin with epidermal ridges, skin without epidermal ridges. For the first time, a change in the architecture of the microvasculature in response to a change in the structure of the epidermis has been described. Knowledge and understanding of the normal processes of change in the skin of the vulva are the main study of any pathology that occurs in this organ.