Previous literature reports suggest that tissue stiffness is a predictor of cancer and metastatic behavior. We have used optical coherence tomography and vibrational analysis (VOCT) to characterize normal skin, scar and a verrucous carcinoma, a squamous cell carcinoma subtype, non-invasively and non-destructively. The results suggest that epidermal thickening and increased keratin production occur in verrucous carcinoma and lead to increases in surface hills and valleys as well as subsequent increases in epidermal stiffness values. Increased stiffness of the epidermis is a result of increased keratin production while the stiffness of the dermis remains similar to that of normal skin, suggesting that dermal changes are not observed in this lesion.

It is concluded that VOCT may ultimately be a useful adjunct to dermoscopy and other clinical tools to identify and characterize lesions as small as 0.2 mm. It is hypothesized that the slow growth potential of verrucous carcinoma may be related to the lack of dermal involvement and that other more invasive skin lesions may be characterized by both epidermal and dermal involvement that would lead to changes in both epidermal and dermal stiffnesses.