Pilot study on photoacoustic imaging and confocal Raman spectroscopy-derived biomarkers for assessing structural and physiological skin changes in atopic dermatitis and metabolic diseases

Atopic dermatitis (AD), a chronic inflammatory condition, is closely associated with obesity and type 2 diabetes mellitus (diabetes/DM). For the first time, using high-resolution photoacoustic imaging (PAI) and in-house-developed handheld confocal Raman spectroscopy (CRS), we studied in 35 subjects the dermal microvascular architecture, epidermal biochemical profiles and skin alterations in AD with DM and obesity. Utilizing the imaging-derived markers, we observed pronounced dermal hypervascularization in DM and obesity, worsening with AD, as reflected by altered oxygen saturation and epidermal biochemicals. Our findings highlight the role of non-invasive biophotonics techniques in assessing metabolic dysfunction during AD progression and management, underscoring their potential as promising non-invasive tools for real-time skin assessment.