Methods for assessing erythema: a critique of parametric and nonparametric techniques

Validation of phototesting for estimation of individual skin ultraviolet sensitivity based on a lengthwise attenuating ultraviolet B field

Conventional skin UV-sensitivity phototesting is based on semi-quantitative assessment of minimal erythema dose (MED). This study demonstrates a method for quantitative MED determination, using a lengthwise attenuating UVB-field combined with tissue viability imaging (TiVi). The study aim was to investigate the agreement between MED acquired by traditional phototest and by the new method. Forty-seven voluntary subjects underwent phototesting with a traditional phototest and with the new technique. Test reading, carried out after 24 h, showed moderate agreement between the methods when assessed with TiVi (Kappa value=0.46) and visually (Kappa value=0.48). For the new method, no systematic differences were seen between outcomes assessed with TiVi or visually (95% CI for the mean difference=-1.6-2.0). In conclusion, the results give promising support for the concept of achieving a more precise MED estimation by combining continuous attenuating UV fields with new available bioengineering technology.

Psychosensorial assessment of skin damage caused by a sliding on artificial turf: the development and validation of a skin damage area and severity index

OBJECTIVES

Injury prevention is an important reason for the development of performance standards in football. Currently, there is no objective method available to classify sliding induced skin injuries, which includes the perceived sliding friendliness of football pitches. The purpose of this study was to develop a non-invasive method for quantification of the observed sliding induced skin damage and evaluate whether there is a correlation between the subjective perceived skin irritation and sliding friendliness.

STUDY DESIGN

Randomized controlled trial.

METHODS

Previously obtained clinical images of sliding induced skin lesions where rated by a dermatologist on the degree of abrasion, erythema and type of exudation. To test the practical feasibility of a proposed Skin Damage and Severity Index (SDASI) to characterize sliding induced skin lesions, a randomized user trial with nine amateur football players was performed. The sliding friendliness of three different grades of infill materials was tested.

RESULTS

The Skin Damage and Severity Index correlates both with the perceived skin irritation (r=-0.53, P=0.02) and sliding friendliness (r=-0.58, P=0.01). Statistical analysis of the individual clinical scores showed that perception of skin irritation and sliding friendliness correlate very well with the degree of erythema and abrasion. However, these scores are independent of the size of the lesion and type of exudation. There was no statistical significant difference found between the three evaluated types of infill and their sliding performance.

CONCLUSIONS

This study demonstrated that the Skin Damage and Severity Index, which is a tool for quantification of a sliding induced skin lesion, correlates very well with the perceived skin irritation and the sliding friendliness.

Prospective controlled clinical and histopathologic study of hidradenitis suppurativa treated with the long-pulsed neodymium:yttrium-aluminium-garnet laser

BACKGROUND

Hidradenitis suppurativa (HS) is a chronic inflammatory disease involving the intertriginous areas.

OBJECTIVE

We sought to conduct clinical and histopathologic evaluation of the efficacy of long-pulsed neodymium:yttrium-aluminium-garnet laser treatment for HS.

METHODS

We conducted a prospective, randomized, right-left within-patient controlled trial for HS (n = 22). Four monthly laser sessions were performed. Disease activity was measured at baseline, and treatment response was assessed before each laser session and monthly for 2 months after the completion of laser treatment, using a modified scoring system based on Sartorius score. Histologic examination was performed at baseline, immediately after laser treatment, and at 1 and 4 weeks after treatment. A patient questionnaire was circulated on the last visit to assess patients' level of satisfaction.

RESULTS

There was progressive improvement in disease activity, most significantly during the 4 months of treatment, which was maintained during the 2-month posttreatment follow-up period. Averaged over all anatomic sites, the percent improvement was 72.7% on the laser treated side, and 22.9% on the control side (P < .05). Histologic examination showed an initial acute neutrophilic infiltrate. Granulomatous inflammation was present on follow-up biopsy specimens 4 weeks later. An inflammatory infiltrate surrounded the hair shaft remnants, denoting destruction of hair follicles.

LIMITATIONS

Small sample size was a limitation.

CONCLUSIONS

Long-pulsed neodymium:yttrium-aluminium-garnet laser, together with topical benzoyl peroxide and clindamycin, is significantly more effective than topical benzoyl peroxide and clindamycin alone for the treatment of HS. Preliminary review of histopathology suggests the mechanism of action is destruction of the hair follicle. The overall success of the treatment in both clearing pre-existing lesions and preventing new eruptions, coupled with high patient satisfaction, makes the neodymium:yttrium-aluminium-garnet laser a promising treatment advance for this highly disabling condition.

Skin color of Koreans: statistical evaluation of affecting factors

BACKGROUND

The L*a*b* three-dimensional coordinate system is the most popular system used to measure skin color. The purpose of this study was to collect standard quantified data on Korean skin color using a chromameter CR-300, and to investigate the relationships among skin color and the general and individual factors that affect it.

METHODS

The 600 subjects used in this study were selected using a three-stage proportionate stratified and quota sampling method. We examined the color of 12 body parts of each subject and calculated the E* value (total color difference between two objects). This study also analyzed factors that may affect skin color.

RESULTS

The average L*a*b* values for the 12 body parts were 61.7462, 9.5618 and 17.0778, respectively. The site of lightest skin was the medial arm (L=63.9249), whereas the darkest was on the forehead (L=58.0044). Redness was highest on the cheek (a=11.8694) and lowest on the medial arm (a=8.1844). Skin color was lighter and more yellow in females than in males, whereas redness was higher in males. In the case of total color difference between two specific sites, the medial upper arm and forearm were the most similar (E=3.23), and the forehead and medial upper arm were the most different in color (E=7.99).

CONCLUSION

The factors that significantly (P<0.01) influenced L* were sex, work place and sunbathing, factors that influenced a* were sex, work place and smoking; and the factors that influenced b* were sunbathing and age.