Megahertz dynamic optical coherence tomography of blisters in human skin

Detecting epidermal blisters in human skin using optical coherence tomography (OCT) is clinically valuable, particularly for diagnosing autoimmune blistering diseases. Dynamic OCT (dOCT) extends conventional structural imaging by providing motion-based contrast sensitive to tissue dynamics. In this study, we analyze the diagnostic potential of dynamic contrast in high-speed (MHz-OCT) and microscopic (mOCT) OCT for blister imaging. We first evaluate whether these systems offer sufficient structural detail for blister detection, comparing them to a clinical reference. Dynamic contrast was then examined in an ex vivo human skin blister model using mOCT, and in vivo, MHz-OCT was subsequently applied to healthy and blistered skin. Our findings demonstrate improved layer delineation and blister localization. We further discuss system-specific image characteristics, artifacts, and their implications for future OCT-based diagnostic workflows.