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Vasudevan S, Vogt WC, Weininger S, Pfefer TJ. Melanometry for objective evaluation of skin pigmentation in pulse oximetry studies. COMMUNICATIONS MEDICINE 2024; 4:138. [PMID: 38992188 PMCID: PMC11239860 DOI: 10.1038/s43856-024-00550-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/11/2024] [Indexed: 07/13/2024] Open
Abstract
Pulse oximetry enables real-time, noninvasive monitoring of arterial blood oxygen levels. However, results can vary with skin color, thus detecting disparities during clinical validation studies requires an accurate measure of skin pigmentation. Recent clinical studies have used subjective methods such as self-reported color, race/ethnicity to categorize skin. Melanometers based on optical reflectance may offer a more effective, objective approach to assess pigmentation. Here, we review melanometry approaches and assess evidence supporting their use as clinical research tools. We compare performance data, including repeatability, robustness to confounders, and compare devices to each other, to subjective methods, and high-quality references. Finally, we propose best practices for evaluating melanometers and discuss alternate optical approaches that may improve accuracy. Whilst evidence indicates that melanometers can provide superior performance to subjective approaches, we encourage additional research and standardization efforts, as these are needed to ensure consistent and reliable results in clinical studies.
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Affiliation(s)
- Sandhya Vasudevan
- Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA.
| | - William C Vogt
- Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - Sandy Weininger
- Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
| | - T Joshua Pfefer
- Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA
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Langeveld M, van de Lande LS, O' Sullivan E, van der Lei B, van Dongen JA. Skin measurement devices to assess skin quality: A systematic review on reliability and validity. Skin Res Technol 2021; 28:212-224. [PMID: 34751474 PMCID: PMC9299221 DOI: 10.1111/srt.13113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 09/25/2021] [Indexed: 11/30/2022]
Abstract
Background Many treatments aim to slow down or reverse the visible signs of skin aging and thereby improve skin quality. Measurement devices are frequently employed to measure the effects of these treatments to improve skin quality, for example, skin elasticity, color, and texture. However, it remains unknown which of these devices is most reliable and valid. Materials and methods MEDLINE, Embase, Cochrane Central, Web of Science, and Google Scholar databases were searched. Instruments were scored on reporting construct validity by means of convergent validity, interobserver, intraobserver, and interinstrument reliability. Results For the evaluation of skin color, 11 studies were included describing 16 measurement devices, analyzing 3172 subjects. The most reliable device for skin color assessment is the Minolta Chromameter CR‐300 due to good interobserver, intraobserver, and interinstrument reliability. For skin elasticity, seven studies assessed nine types of devices analyzing 290 subjects in total. No intra and interobserver reliability was reported. Skin texture was assessed in two studies evaluating 72 subjects using three different types of measurement devices. The PRIMOS device reported excellent intra and interobserver reliability. None of the included reviewed devices could be determined to be valid based on construct validity. Conclusion The most reliable devices to evaluate skin color and texture in ordinary skin were, respectively, the Minolta Chromameter and PRIMOS. No reliable device is available to measure skin elasticity in ordinary skin and none of the included devices could be determined to be designated as valid.
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Affiliation(s)
- Mirte Langeveld
- Medical Faculty, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Lara S van de Lande
- Craniofacial Unit Great Ormond Street Hospital for Children and UCL Great Ormond Street Institute of Child Health, London, UK
| | - Eimear O' Sullivan
- Craniofacial Unit Great Ormond Street Hospital for Children and UCL Great Ormond Street Institute of Child Health, London, UK
| | - Berend van der Lei
- Department of Plastic Surgery, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
| | - Joris A van Dongen
- Department of Plastic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
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Application of Various Methods to Evaluate the Postoperative Characteristics of Expanded Pedicled Deltopectoral Flap for Large Facial Scars. J Craniofac Surg 2021; 33:1130-1135. [PMID: 34560753 DOI: 10.1097/scs.0000000000008221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT The expanded pedicled deltopectoral flap (EPDF) has been widely used to repair large facial scars. Although doctors and patients are usually satisfied with the outcomes, the actual functional recovery and cosmetic effects of EPDF are still unknown. It is, therefore, necessary to objectively investigate the effect of transferred EPDF by using a variety of methods. From January 2008 to December 2018, 52 patients who underwent EPDF surgery at Xijing Hospital were enrolled. Sense of touch, static 2-point discrimination, elasticity, and color were measured. Thermesthesia and algesthesia were also tested. Postoperative scars were evaluated using the patient and observer scar assessment scale. Satisfaction of patients, doctors, and laypersons was investigated. The algaesthesis, thalposis, and rhigosis scores were 4.7 ± 0.7, 3.7 ± 0.9, and 4.5 ± 0.8, respectively. The tactile score was 0.3 ± 0.2 mN, and 2-point discrimination was 10.1 ± 4.8 mm. L*, a*, hemoglobin, and melanin content of the flaps were significantly different when compared with normal skin (P < 0.05). The satisfaction of doctors, patients, and laypersons was 88.5%, 71.2%, and 67.3%, respectively. The higher satisfaction of patients was mainly associated with the smaller color difference between the flap and the surrounding skin, and lower patient and observer scar assessment scale score. These results confirm that excellent functional recovery and reliable cosmetic effects are observed when facial scars are repaired with EPDF. The methods used in this study can be applied to the evaluation of functional recovery and cosmetic outcomes of transferred flaps, which may provide a more comprehensive understanding of flap assessment.
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Qin J, Qiao L, Hu J, Xu J, Du L, Wang Q, Ye R. New method for large-scale facial skin sebum quantification and skin type classification. J Cosmet Dermatol 2020; 20:677-683. [PMID: 32585060 DOI: 10.1111/jocd.13576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/01/2020] [Accepted: 06/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The demand for personalized skin care is increasing rapidly in recent years. In order to provide suitable products for different customers, an accurate assessment of the skin condition is required. It is necessary to establish a remote and convenient method for quantifying skin condition. MATERIALS AND METHODS We established a new method for quantifying the facial sebum excretion, using Sebutape as well as a model for objective skin type classification. RESULTS In total, 2173 sebum quantification samples were collected and categorized into 4 skin types. We found good agreement between subjective and objective skin types. 60.33% of the detection is consistent, and the proportion of discrepancies is only 0.55%. The main mismatch is caused by broad criteria for combination type classification. Quantifying the sebum excretion will help to describe and analyze the skin state easily. We found sebum levels in Chinese women peak at the age between 20 and 30 and decrease dramatically after age 40s. CONCLUSION This new sebum quantitative method is well consistent to self-report skin type. In addition, it provides a powerful tool for the cosmetic industry to evaluate skin condition precisely and recommend personalized products accordingly.
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Affiliation(s)
- Jingjing Qin
- Department of Dermatology, Forest Industry Worker Hospital of Shaanxi Province, Xi'an, PR China
| | - Liyuan Qiao
- Department of Science, Inertia Shanghai Biotechnology Co., Ltd, Shanghai, PR China
| | - Jingjing Hu
- Department of Science, Inertia Shanghai Biotechnology Co., Ltd, Shanghai, PR China
| | - Jichao Xu
- Department of Science, Inertia Shanghai Biotechnology Co., Ltd, Shanghai, PR China
| | - Le Du
- Department of Science, Inertia Shanghai Biotechnology Co., Ltd, Shanghai, PR China
| | - Qianqian Wang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Rui Ye
- Department of Science, Inertia Shanghai Biotechnology Co., Ltd, Shanghai, PR China
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Wang H, Zhang Q, Mao G, Conroy O, Pyatski Y, Fevola MJ, Cula GO, Maitra P, Mendelsohn R, Flach CR. Novel confocal Raman microscopy method to investigate hydration mechanisms in human skin. Skin Res Technol 2019; 25:653-661. [PMID: 30932226 DOI: 10.1111/srt.12698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/14/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Skin hydration is essential for maintaining stratum corneum (SC) flexibility and facilitating maturation events. Moisturizers contain multiple ingredients to maintain and improve skin hydration although a complete understanding of hydration mechanisms is lacking. The ability to differentiate the source of the hydration (water from the environment or deeper skin regions) upon application of product will aid in designing more efficacious formulations. MATERIALS AND METHODS Novel confocal Raman microscopy (CRM) experiments allow us to investigate mechanisms and levels of hydration in the SC. Using deuterium oxide (D2 O) as a probe permits the differentiation of endogenous water (H2 O) from exogenous D2 O. Following topical application of D2 O, we first compare in vivo skin depth profiles with those obtained using ex vivo skin. Additional ex vivo experiments are conducted to quantify the kinetics of D2 O diffusion in the epidermis by introducing D2 O under the dermis. RESULTS Relative D2 O depth profiles from in vivo and ex vivo measurements compare well considering procedural and instrumental differences. Additional in vivo experiments where D2 O was applied following topical glycerin application increased the longevity of D2 O in the SC. Reproducible rates of D2 O diffusion as a function of depth have been established for experiments where D2 O is introduced under ex vivo skin. CONCLUSION Unique information regarding hydration mechanisms are obtained from CRM experiments using D2 O as a probe. The source and relative rates of hydration can be delineated using ex vivo skin with D2 O underneath. One can envision comparing these depth-dependent rates in the presence and absence of topically applied hydrating agents to obtain mechanistic information.
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Affiliation(s)
- Hequn Wang
- Johnson and Johnson Consumer Companies, Inc., Skillman, New Jersey
| | - Qihong Zhang
- Department of Chemistry, Rutgers University, Newark, New Jersey
| | - Guangru Mao
- Johnson and Johnson Consumer Companies, Inc., Skillman, New Jersey
| | - Oscar Conroy
- Johnson and Johnson Consumer Companies, Inc., Skillman, New Jersey
| | - Yelena Pyatski
- Department of Chemistry, Rutgers University, Newark, New Jersey
| | - Michael J Fevola
- Johnson and Johnson Consumer Companies, Inc., Skillman, New Jersey
| | | | | | | | - Carol R Flach
- Department of Chemistry, Rutgers University, Newark, New Jersey
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Objective and Patient-reported Assessments of Skin Grafts and Keystone Flaps-A Pilot Retrospective Cohort Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 6:e2024. [PMID: 30881809 PMCID: PMC6414100 DOI: 10.1097/gox.0000000000002024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 09/21/2018] [Indexed: 11/29/2022]
Abstract
Background: The keystone perforator island flap provides a versatile form of reconstruction. Perceived benefits include better donor-recipient color match, less contour defect, and fewer complications. To date, there has been no high-quality evidence comparing keystone flaps to split-thickness skin grafts (SSG) from both a qualitative and quantitative point of view. Methods: The Objective and Patient Reported Assessments of Skin grafts versus Keystone flap cohort study compares keystone flaps with SSGs for the reconstruction of skin cancer defects. Patient-reported outcome measures were collected using the EuroQol 5 dimension scale and Patient and Observer Scar Assessment Scale (POSAS) questionnaires. Objective assessments of skin quality were assessed with the Courage and Khazaka system. Cost analysis was also performed. Results: Thirty-eight patients were studied: 20 keystone flaps and 18 SSGs. The keystone group had higher EuroQol 5 dimension scale scores (keystone median = 1.0; SSG median = 0.832; P = 0.641) indicating better general quality of life and lower POSAS scores indicating better disease/condition specific quality of life (keystone mean = 27.7; SSG mean = 35.7; P = 0.323). Observer POSAS scores were significantly lower in the keystone group compared with the SSG group (keystone mean = 10.889; SSG mean = 17.313; P < 0.001). Preservation of sensation was significantly better in keystone flaps (P = 0.006). There was an average £158/$207 (15%) saving when performing a keystone flap. Conclusion: This pilot study demonstrates a number of possible benefits of keystone flaps over SSGs. The results demonstrate the need for further research comparing these reconstructive options. We propose a prospective, controlled study using the methods developed in this pilot study.
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Wang X, Shu X, Li Z, Huo W, Zou L, Tang Y, Li L. Comparison of two kinds of skin imaging analysis software: VISIA ® from Canfield and IPP ® from Media Cybernetics. Skin Res Technol 2018; 24:379-385. [PMID: 29377397 DOI: 10.1111/srt.12440] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Skin imaging analysis, acting as a supplement to noninvasive bioengineering devices, has been widely used in medical cosmetology and cosmetic product evaluation. The main aim of this study is to assess the differences and correlations in measuring skin spots, wrinkles, vascular features, porphyrin, and pore between two commercially available image analysis software. MATERIALS AND METHODS Seventy healthy women were included in the study. Before taking pictures, the dermatologist evaluated subjects' skin conditions. Test sites included the forehead, cheek, and periorbital skin. A 2 × 2 cm cardboard was used to make a mark on the skin surface. Pictures were taken using VISIA® under three kinds light conditions and analyzed using VISIA® and IPP® respectively. RESULTS (1) Skin pore, red area, ultraviolet spot, brown spot, porphyrin, and wrinkle measured with VISIA® were correlated with those measured with IPP® (P < .01). (2) Spot, wrinkle, fine line, brown spot, and red area analyzed with VISIA® were correlated with age on the forehead and periorbital skin (P < .05). L-value, Crow's feet, ultraviolet spot, brown spot, and red area analyzed with IPP® were correlated with age on the periorbital skin (P < .05). (3) L-value, spot, wrinkle, fine line, porphyrin, red area, and pore analyzed with VISIA® and IPP® showed correlations with the subjective evaluation scores (P < .05). CONCLUSIONS VISIA® and IPP® showed acceptable correlation in measuring various skin conditions. VISIA® showed a high sensibility when measured on the forehead skin. IPP® is available as an alternative software program to evaluate skin features.
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Affiliation(s)
- X Wang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - X Shu
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Z Li
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, China
| | - W Huo
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, China
| | - L Zou
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Y Tang
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, China
| | - L Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
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Mayrovitz HN, Corbitt K, Grammenos A, Abello A, Mammino J. Skin indentation firmness and tissue dielectric constant assessed in face, neck, and arm skin of young healthy women. Skin Res Technol 2016; 23:112-120. [DOI: 10.1111/srt.12310] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Harvey N. Mayrovitz
- College of Medical Sciences; Nova Southeastern University; Ft. Lauderdale FL USA
| | - Kelly Corbitt
- College of Osteopathic Medicine; Nova Southeastern University; Ft. Lauderdale FL USA
| | - Alexandra Grammenos
- College of Osteopathic Medicine; Nova Southeastern University; Ft. Lauderdale FL USA
| | - Allen Abello
- College of Osteopathic Medicine; Nova Southeastern University; Ft. Lauderdale FL USA
| | - Jason Mammino
- College of Osteopathic Medicine; Nova Southeastern University; Ft. Lauderdale FL USA
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Li CX, Han CL, Zeng K, Zhang XB, Ma ZL. Clinical, demographic and histopathological features of symmetrical acral keratoderma. Br J Dermatol 2014; 170:948-51. [PMID: 24341804 DOI: 10.1111/bjd.12754] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2013] [Indexed: 11/30/2022]
Affiliation(s)
- C.-X. Li
- Department of Dermatology; Nanfang Hospital; South Medical University; Guangzhou China
- Department of Dermatology; Dongguan Institute of Dermatology; Dongguan China
| | - C.-L. Han
- Department of Dermatology; Dongguan Institute of Dermatology; Dongguan China
| | - K. Zeng
- Department of Dermatology; Nanfang Hospital; South Medical University; Guangzhou China
| | - X.-B. Zhang
- Department of Dermatology; Guangzhou Institute of Dermatology; Guangzhou China
| | - Z.-L. Ma
- Department of Dermatology; Dongguan Institute of Dermatology; Dongguan China
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