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Peng Y, Wang B, Mao M, Li J, Shi W, Zhao H, Huang Z, Zhao Z, Huang C, Jian D. Clinical characteristics of the well-defined upper eyelid vascular network pattern in patients with rosacea. Int J Dermatol 2024; 63:337-344. [PMID: 38197322 DOI: 10.1111/ijd.16946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/03/2023] [Accepted: 11/18/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Rosacea is a chronic inflammatory skin disease. The diagnosis is based on the symptoms and physical signs, which still lacks objective laboratory tests or imaging tests. OBJECTIVES To propose and evaluate the upper eyelid network pattern in rosacea. METHODS Participants included patients diagnosed with rosacea, other facial erythematous skin diseases, and normal controls, all of whom underwent full-face imaging utilizing the VISIA® system software. According to these images, researchers evaluated the condition of the upper eyelid vascular network, developed the grading scale and then compared the difference of distribution in the three groups. RESULTS The occurrence rate of upper eyelid vascular network in rosacea was significantly higher than that in other facial erythematous skin diseases (84.3 vs. 32.0%, P < 0.001) and normal controls (84.3 vs. 28.0%, P < 0.001). The upper eyelid vascular network pattern was proposed (none [no clearly reticular vessels], mild [10-50% area of reticular vessels], moderate-to-severe [>50% area of reticular vessels]). Moderate-to-severe grade was defined as well-defined upper eyelid vascular network pattern, which was specific to patients with rosacea (rosacea vs. other facial erythematous skin diseases, adjusted odds ratio [aOR] = 5.814, 95% confidence interval [CI]: 3.899-8.670) (rosacea vs. heathy controls, aOR = 12.628, 95% CI: 8.334-19.112). The severity of the well-defined pattern had no significant association with age, duration, and phenotypes of rosacea (P > 0.05). CONCLUSION The well-defined upper eyelid vascular network pattern specifically appeared in patients with rosacea, which could be a possible clue to the diagnosis of rosacea.
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Affiliation(s)
- Yiran Peng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ben Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, China
| | - Mengping Mao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, China
| | - Wei Shi
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Huimin Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ziyang Huang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhixiang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, China
| | - Chuchu Huang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Dan Jian
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Huang Y, He J, Zhang S, Tang Y, Wang B, Jian D, Xie H, Li J, Chen F, Zhao Z. A novel multi-layer perceptron model for assessing the diagnostic value of non-invasive imaging instruments for rosacea. PeerJ 2022; 10:e13917. [PMID: 35996670 PMCID: PMC9392450 DOI: 10.7717/peerj.13917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/28/2022] [Indexed: 01/19/2023] Open
Abstract
Background Reflectance confocal microscopy (RCM), VISIA, and dermoscopy have emerged as promising tools for objective diagnosis and assessment of rosacea. However, little is known about the diagnostic value of these imaging systems for rosacea. Objectives To assess the diagnostic value of RCM, VISIA, and dermoscopy for rosacea by establishing a novel multilayer perceptron (MLP) model. Methods A total of 520 patients with rosacea and other facial diseases were included in this study. A total of 474 samples of dermoscopy data, 374 samples of RCM data, 434 samples of VISIA data, and 291 samples containing three data sources were collected. An MLP model was built with the total data to explore the association between the imageological features of each instrument and the probability of rosacea. Results Our MLP model revealed that the area under the receiver operating characteristic curve (AUROC) values of RCM, VISIA and dermoscopy for diagnosing rosacea were 0.5233, 0.5646 and 0.7971, respectively. The integration of these three tools with clinical data could further improve the accuracy of the predictive diagnosis to 0.8385. For the imageological features of each tool, abnormalities (hyperkeratosis or parakeratosis) in the stratum corneum were effective variables for excluding rosacea (odds ratio [OR], 0.4333) under RCM. The indicators of rosacea under VISIA included overall severity of erythema, erythema involving the cheek or superciliary arch, visible red blood vessels, and papules (OR = 2.2745, 3.1592, 1.8365, 2.8647, and 1.4260, respectively). The candidate variables of dermoscopy included yellow background, white background, uniform distribution of vessels, branched vessels, and reticular blood vessels (OR = 0.4259, 0.4949, 2.2858, 3.7444, and 2.4576, respectively). Conclusions RCM, dermoscopy, and VISIA each can present several imageological features and were of certain value for assisting rosacea diagnosis. The combined analysis of these three tools using our MLP model may be useful for improving the accuracy of diagnosing rosacea.
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Affiliation(s)
- Yingxue Huang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jieyu He
- School of Public Health, Kunming Medical University, Kuming, Yunnan, China
| | - Shuping Zhang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yan Tang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ben Wang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Dan Jian
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hongfu Xie
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Feng Chen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhixiang Zhao
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China
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Pan Y, Jia K, Yan S, Jiang X. Effectiveness of VISIA system in evaluating the severity of rosacea. Skin Res Technol 2022; 28:740-748. [PMID: 35818722 PMCID: PMC9907647 DOI: 10.1111/srt.13194] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/19/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Rosacea is a facial chronic inflammatory skin disease with almost 5.5% prevalence. Although there are various scales of rosacea, they are objective and discordant among different dermatologists. Noninvasive objective measurements such as VISIA system might play essential roles in the diagnosis and evaluation of rosacea. Here, we intended to reveal the effectiveness of VISIA system in rosacea. MATERIALS AND METHODS A number of 563 participants diagnosed with facial rosacea were enrolled in study. They all received both full-face image-shoot by VISIA system with quantitative analysis software and physician's assessment via five different scales, including investigator global assessment (IGA), clinician erythema assessment (CEA), numerical score, the National Rosacea Society (NRS) grading system and telangiectasis. RESULTS Absolute score and percentile of red area had significant correlations with IGA and CEA, whereas red area had no significant correlation with numerical score, NRS and telangiectasis. Red area in erythematotelangiectatic rosacea patients demonstrated the highest correlation with IGA and CEA, especially in those aged between 51 and 60. Besides red area, pigmentation parameters in VISIA system (brown spot) also showed significant correlation with IGA and CEA. CONCLUSION VISIA system might be an effective measurement in the assessment of rosacea severity.
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Affiliation(s)
- Yu Pan
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Kaiyu Jia
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Sihan Yan
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
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Lee E, Cho C, Ha J. Biophysical properties of redness-prone skin in Korean women. J Cosmet Dermatol 2021; 21:4035-4041. [PMID: 34967485 DOI: 10.1111/jocd.14722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/16/2021] [Accepted: 12/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Facial skin redness can have a negative impact on the quality of life. In this study, we investigated the skin biophysical parameters associated with facial skin redness as a function of aging. METHODS Our aims were as follows: (1) to understand the impact of non-pathological facial skin redness on the quality of life of Korean women through a survey; and (2) compare skin biophysical properties between women with and without facial skin redness. RESULTS Women aged between 20 and 39 years perceived their own facial skin redness at a higher rate than those aged ≥40 years. In addition, in redness-prone women, the intensity of skin redness and skin surface perfusion were higher, while skin hydration was lower regardless of age. In redness-prone women aged ≥40 years, the values for transepidermal water loss, elasticity, and skin thickness were lower, and the mean pore depth was greater. Facial redness intensity was higher, and the distribution was wider in redness-prone younger women, while only redness intensity increased in the older age group. CONCLUSIONS Overall, redness-prone women aged ≥40 years had weaker skin properties. Our study indicated the age-related biophysical characteristics of non-pathological facial skin redness. We believe that our findings will help improve its negative effects.
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Affiliation(s)
- Eunyoung Lee
- Skin Research Center, Institut d'Expertise Clinique (IEC) KOREA, Suwon, Korea
| | - Changhui Cho
- Skin Research Center, Institut d'Expertise Clinique (IEC) KOREA, Suwon, Korea
| | - Jaehyoun Ha
- Skin Research Center, Institut d'Expertise Clinique (IEC) KOREA, Suwon, Korea
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Seo JI, Ham HI, Baek JH, Shin MK. An objective skin-type classification based on non-invasive biophysical parameters. J Eur Acad Dermatol Venereol 2021; 36:444-452. [PMID: 34747517 DOI: 10.1111/jdv.17793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/14/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Despite the invention of various non-invasive bioengineering tools, skin-type analysis has largely been based on subjective assessments. However, advancements in the functional cosmetic industry and artificial intelligence-assisted dermatology are creating a greater demand for an objective skin-type classification system. OBJECTIVES To propose an objective skin-type classification system solely based on non-invasive, bioengineering devices; provide reference values applicable to the Korean population; and compare our reference values with those of published studies. METHODS Biophysical parameter measurements were obtained from the 2018 International Skin Characteristics Data Bank Project conducted by the Foundation of Korea Cosmetic Industry Institute. The participants were 434 healthy South Korean adults. Each participant was assessed using eight bioengineering devices (Tewameter® , pH-meter® , Corneometer® , Sebumeter® , Cutometer® , Spectrophotometer® , PRIMOS® lite, and Janus® ). The measurements were divided into tertiles to determine reference points. RESULTS Our objective skin-type classification consists of five main categories (sensitivity, hydration, oiliness, elasticity, and skin tone) and five corresponding subcategories (erythema, roughness, pores, wrinkles, and pigmentation, respectively). Each skin type was assigned based on the reference point of the biophysical parameter, which was established as the tertile value associated with 'unfavourable' skin characteristics. Individuals were categorized as having sensitive skin when the TEWL scores were over 18.0 g/m2 /h or the pH was over 5.45; dehydrated skin when the corneometric value measured below 47.17 A.U.; oily skin when the sebumetric value exceeded 70 μg/cm2 ; and loose skin when the cutometric R2 value was below 0.68 E/mm. CONCLUSIONS This study is the first to provide a comprehensive skin-type classification system based solely on non-invasive biophysical parameters. As measurement data accumulate, the reference points will progress to become more accurate, and they will be subdivided according to gender, age, and ethnic group. Therefore, our classification system serves as a basis for artificial intelligence-based skin-type analysis.
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Affiliation(s)
- J I Seo
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - H I Ham
- Dermapro Skin Research Center, DERMAPRO Ltd., Seoul, Republic of Korea
| | - J H Baek
- Dermapro Skin Research Center, DERMAPRO Ltd., Seoul, Republic of Korea
| | - M K Shin
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
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Chaturvedi P, Worsley PR, Zanelli G, Kroon W, Bader DL. Quantifying skin sensitivity caused by mechanical insults: A review. Skin Res Technol 2021; 28:187-199. [PMID: 34708455 PMCID: PMC9298205 DOI: 10.1111/srt.13104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Skin sensitivity (SS) is a commonly occurring response to a range of stimuli, including environmental conditions (e.g., sun exposure), chemical irritants (e.g., soaps and cosmetics), and mechanical forces (e.g., while shaving). From both industry and academia, many efforts have been taken to quantify the characteristics of SS in a standardised manner, but the study is hindered by the lack of an objective definition. METHODS A review of the scientific literature regarding different parameters attributed to the loss of skin integrity and linked with exhibition of SS was conducted. Articles included were screened for mechanical stimulation of the skin, with objective quantification of tissue responses using biophysical or imaging techniques. Additionally, studies where cohorts of SS and non-SS individuals were reported have been critiqued. RESULTS The findings identified that the structure and function of the stratum corneum and its effective barrier properties are closely associated with SS. Thus, an array of skin tissue responses has been selected for characterization of SS due to mechanical stimuli, including: transepidermal water loss, hydration, redness, temperature, and sebum index. Additionally, certain imaging tools allow quantification of the superficial skin layers, providing structural characteristics underlying SS. CONCLUSION This review proposes a multimodal approach for identification of SS, providing a means to characterise skin tissue responses objectively. Optical coherence tomography (OCT) has been suggested as a suitable tool for dermatological research with clinical applications. Such an approach would enhance the knowledge underlying the multifactorial nature of SS and aid the development of personalised solutions in medical and consumer devices.
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Affiliation(s)
- Pakhi Chaturvedi
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands.,School of Health Sciences, University of Southampton, Southampton, UK
| | - Peter R Worsley
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Giulia Zanelli
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands
| | - Wilco Kroon
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands
| | - Dan L Bader
- School of Health Sciences, University of Southampton, Southampton, UK
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Humphrey S, Manson Brown S, Cross SJ, Mehta R. Defining Skin Quality: Clinical Relevance, Terminology, and Assessment. Dermatol Surg 2021; 47:974-981. [PMID: 34148998 PMCID: PMC8231670 DOI: 10.1097/dss.0000000000003079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Flawless skin is one of the most universally desired features, and demand for improvements in skin quality is growing rapidly. Skin quality has been shown to substantially impact emotional health, quality of life, self-perception, and interactions with others. Although skin quality improvements are a common end point in studies of cosmeceuticals, they are rarely assessed in clinical studies of other aesthetic treatments and products. Descriptive terminology for skin quality parameters also varies considerably within the aesthetic field, relying on a range of redundant and occasionally contradictory descriptors. In short, skin quality has not been clearly defined. OBJECTIVE The goal of this review is to highlight the importance of skin quality to patients and physicians, explore known and unknown factors comprising skin quality, and provide clarity regarding terminology, descriptors, and evaluation tools for assessing skin quality. MATERIALS AND METHODS A review of the literature on skin quality was performed without limitation on publication date. Relevant articles are presented. RESULTS AND CONCLUSION We propose a framework of attributes contributing to skin quality rooted in 3 fundamental categories-visible, mechanical, and topographical-with the aim to provide information to help guide clinicians and inform future clinical studies.
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Affiliation(s)
- Shannon Humphrey
- Humphrey Cosmetic Dermatology, Vancouver, British Columbia, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Rahul Mehta
- Allergan Aesthetics, an AbbVie Company, Irvine, California
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Dall'Oglio F, Lacarrubba F, Micali G. Erythema-directed digital photography and colorimeter scores correlate with rosacea erythema evaluation in patients under treatment with topical ivermectin. Dermatol Ther 2021; 34:e14920. [PMID: 33641260 DOI: 10.1111/dth.14920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/21/2021] [Accepted: 02/19/2021] [Indexed: 11/30/2022]
Abstract
Inflammatory rosacea is clinically characterized by persistent erythema and inflammatory lesions. Its severity is generally based on clinical observation that may be cumbersome. The aim of this study was to assess if erythema-directed digital photography (EEDP) and colorimeter (COL) correlate and are concordant with clinical evaluation of erythema degree of rosacea under topical treatment. Thirty naïve patients with mild/moderate inflammatory rosacea were instructed to apply ivermectin cream for 8 weeks. Erythema degree was performed at baseline, and at 2, 4, 6, and 8 weeks by clinician erythema assessment based on 5-point severity scale (from 0 = no erythema to 4 = fiery redness), and by instrumental evaluation by EDDP using the same 5-point scale of clinical assessment and by COL using a 5-point scale (from 0 = <1 units = no erythema to 4 > 12 units = fiery redness). Concordance and correlation analysis were performed using Cohen's Kappa coefficient and Correlation Coefficient test respectively. At baseline a statistically significant concordance/correlation value between EDDP and COL was observed. At 2 weeks, the statistical concordance/correlation value between instrumentals were both increased, along with a slight significant concordance between clinical assessment and erythema-directed digital photography. At 4, 6 and 8 weeks, a statistically significant increase of concordance/correlation value among all the considered parameters from baseline was found. The results of our study showed that at baseline and during the early treatment stage both EDDP and COL were able to appreciate more accurately the erythema grade compared to clinical observation supporting the use of non-invasive techniques for a more objective evaluation of erythema in rosacea.
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9
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Logger JGM, Driessen RJB, de Jong EMGJ, van Erp PEJ. Value of GPSkin for the measurement of skin barrier impairment and for monitoring of rosacea treatment in daily practice. Skin Res Technol 2020; 27:15-23. [PMID: 32573826 PMCID: PMC7984125 DOI: 10.1111/srt.12900] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/04/2020] [Indexed: 12/23/2022]
Abstract
Background Stratum corneum hydration (SCH) and transepidermal water loss (TEWL) provide useful information about skin barrier function. This study aimed to determine the value of GPSkin Pro, a new handheld device determining both SCH and TEWL, to measure skin barrier impairment and to monitor barrier function in rosacea in daily practice. Materials and Methods Two pilots were performed. Pilot 1: in 27 healthy participants, GPSkin SCH and TEWL were compared to Aquaflux® and Epsilon® values at the forearm before and after skin barrier perturbation via tapestripping. Moreover, GPSkin values were measured at both cheeks without intervention. Pilot 2: in 16 rosacea patients, GPSkin measurements were performed at the forearm, and at both cheeks before and during anti‐inflammatory treatment. They were compared to clinical symptoms and to GPSkin values from pilot 1. Results Pilot 1: after merging data from before and after tapestripping, a strong correlation was observed between GPSkin TEWL and Aquaflux® (Rs = 0.9256), and GPSkin SCH and Epsilon® (Rs = 0.8798). Pilot 2: SCH was significantly lower at the cheeks of rosacea patients compared to controls, with a normalizing trend during successful treatment. TEWL was comparable among patients and controls and did not change during treatment at all locations. Conclusion The GPSkin determines TEWL and SCH accurately in healthy and impaired skin barrier state and can monitor skin barrier function in rosacea during treatment. The GPSkin device is much more practical compared to previous skin barrier tools when used in clinical practice. Its further validation in other inflammatory skin diseases is recommended.
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Affiliation(s)
- Jade G M Logger
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rieke J B Driessen
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Piet E J van Erp
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
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10
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Logger JGM, de Jong EMGJ, Driessen RJB, van Erp PEJ. Evaluation of a simple image-based tool to quantify facial erythema in rosacea during treatment. Skin Res Technol 2020; 26:804-812. [PMID: 32537843 PMCID: PMC7754330 DOI: 10.1111/srt.12878] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/22/2020] [Indexed: 12/13/2022]
Abstract
Background Facial erythema is a common symptom in rosacea. To overcome subjectivity in scoring erythema severity, objective redness quantification is desirable. This study evaluated an image‐based erythema quantification tool to monitor facial erythema in rosacea patients during treatment and compared these values to clinical scores. Materials and Methods Twenty‐one rosacea patients were treated with topical ivermectin for 16 weeks. Clinical erythema scores and clinical photographs were taken at week 0, 6, 16 and 28. Using ImageJ, RGB images were split into red, green and blue channels to measure the green/red ratio of lesional skin compared with a green sticker. With CIELAB colour space, a* (indicating colour from green to red) of a lesional and non‐lesional facial site was measured, calculating ∆a*. Interobserver concordance and correlation between quantitative and clinical erythema values were determined. Results Treatment resulted in reduction of clinical erythema scores. No significant changes in red/green ratios were measured. Lesional a* and ∆a* significantly decreased from baseline to week 16 and 28 (P < .05). A weak correlation existed between clinical scores and lesional a* (Rs = 0.37), and between clinical scores and ∆a* (Rs = 0.30), with a clear trend towards higher a* and ∆a* for higher clinical scores. Interobserver correlation was high (R2 = 0.82). Conclusion ImageJ is a simple, rapid, objective and reproducible tool to monitor erythema in rosacea patients during treatment. The photographs allow retrospective analysis, evaluation of large and small lesions, and discrimination of subtle redness differences. We recommend using lesional a* to monitor erythema of inflammatory dermatoses in clinical practice.
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Affiliation(s)
- Jade G M Logger
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rieke J B Driessen
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Piet E J van Erp
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
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Ma Y, Li L, Chen J, Chen T, Yuan C. Distinguishing rosacea from sensitive skin by reflectance confocal microscopy. Skin Res Technol 2020; 26:671-674. [PMID: 32180258 DOI: 10.1111/srt.12851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 02/29/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The updated standard classification and pathophysiology of rosacea have provided clear and meaningful evaluation parameters; however, differentiating rosacea from sensitive skin (SS) remained an obstacle for dermatologists around the world, especially in China. Herein, we aimed to find a better characteristic to distinguish rosacea from SS by using reflectance confocal microscopy (RCM). METHOD Forty rosacea patients and 143 healthy subjects were recruited in this study. Firstly, a SS questionnaire and a lactic acid sting test were conducted among healthy subjects. Next, two major groups were divided out, including a SS group (40 subjects) and a normal skin control group (NS, 60 subjects). The cutaneous structures of face and fossa cubitalia were imaged by RCM. RESULTS We found that more parakeratosis, honeycomb pattern, spongiform edema, and dermal papillae (P < .05) in rosacea patients than that of the NS group, whereas there were no significant differences, were found in rosacea patients and the SS group. Strikingly, we found that rosacea patients have a larger depth of honeycomb pattern than that of SS subjects (P < .05). But, the epidermal thickness of rosacea did not differ from that of SS groups. There was also no significant difference of epidermal thickness and honeycomb structure depth between rosacea patients and NS group. CONCLUSION From the RCM images of parakeratosis, honeycomb pattern, spongiform edema, and dermal papillae, we found that RCM might be a faithful tool to distinguish rosacea from NS group. The depth of honeycomb structure of SS was more superficial than rosacea patients, whereas no significant difference between rosacea patients and NS group. RCM may provide a new method for evaluating the development of rosacea although it failed to distinguish rosacea and SS effectively.
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Affiliation(s)
- Yafeng Ma
- Department of Skin and Cosmetic Research, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China
| | - Lulu Li
- Department of Skin and Cosmetic Research, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China
| | - Jia Chen
- Department of Dermatopathology, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China
| | - Tian Chen
- Dr.Yu Research Center, Shanghai Jahwa United Co., Ltd., Shanghai, China
| | - Chao Yuan
- Department of Skin and Cosmetic Research, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China
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Affiliation(s)
- J Tan
- Western University, Windsor Campus, Windsor, ON, Canada
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Singh SK. Superglue slide impression (SSI) method: a novel diagnostic application for canine demodicosis. EXPERIMENTAL & APPLIED ACAROLOGY 2019; 79:387-393. [PMID: 31768807 DOI: 10.1007/s10493-019-00444-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/20/2019] [Indexed: 06/10/2023]
Abstract
The conventional gold standard diagnostic method for canine demodicosis, the deep skin scrapings (DSS), is traumatic to the animal and appears aggressive in the eyes of the owner. A less invasive, sensitive, easy-to-perform and field-oriented diagnostic method for the rapid diagnosis of canine demodicosis is warranted. The present study aimed to develop a rapid less invasive diagnostic method using superglue (cyanoacrylate adhesive) slide impression (SSI). Ninety-seven client-owned dogs presented with clinical symptoms and signs suggestive of demodicosis were examined using SSI for detection of Demodex mites. A clean microscope slide was taken and a drop of superglue was placed on the slide. Immediately, the superglue-bearing slide surface was applied to the previously squeezed selected skin lesion with gentle pressure for 30 s. The slide was removed from the skin lesion and a drop of immersion oil was placed over the SSI. Another clean cover slide was applied and examined under the microscope at low-power magnification (× 10 lens). Of the 97 dogs, 90 dogs (92.8%) were detected positive for demodectic mites using the SSI method, whereas 86 (88.7%) dogs were found positive using the DSS technique. The SSI method was found to be equally sensitive to the DSS method. In summary, the SSI method is a new quick, sensitive, easy-to-perform, owner- and animal-friendly, less traumatic and field-oriented diagnostic application for demodicosis in dogs. It can be used for harvesting the live demodectic mites and monitoring miticidal therapies.
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Affiliation(s)
- Shanker K Singh
- Department of Veterinary Medicine, College of Veterinary Science and Animal Husbandry, U.P. Pandit Deen Dayal Upadhyaya Pashu-Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, U.P., 281 001, India.
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