Measurement of Electrical Skin Impedance of Dermal-Visceral Zones as a Diagnostic Tool for Disorders of the Immune System

A Scoping Review of Non-invasive Imaging Modalities in Dermatological Disease: Potential Novel Biomarkers in Hidradenitis Suppurativa

Background: The development of imaging-based biomarkers has the potential to overcome major challenges in the accurate and reproducible assessment of disease severity and response to novel therapies in Hidradenitis Suppurativa (HS). Understanding the advantages and limitations of existing non-invasive imaging modalities in dermatological disease will aid in the development of hypotheses and inform the design of future studies. Methods: A scoping review was performed using Medline, Embase, Web of Science Databases and evaluation of "gray literature" until June 30, 2019. Citations were examined according to pre-defined inclusion and exclusion criteria. Citations were reviewed by two independent reviewers. Narrative Synthesis was used to summarize data, structured by imaging modality. Results: Non-invasive imaging modalities, such as ultrasound, MRI, RCM, EIS, OCT, and MIT, were identified. Only ultrasound, MRI and MIT have been used in HS. Image modalities vary in image depth, resolution, cost, accessibility and correlation with known aspects of disease activity in HS. Discussion and Conclusion: The benefits and limitations of each imaging modality are products of cost, accessibility, validity and reliability. An additional hurdle to the development of image-based biomarkers in HS is a lack of established analytical benchmarks that can be correlated with existing biological, inflammatory and clinical parameters. This review has identified potential imaging biomarkers, as well as relevant analytical benchmarks that reflect the presence or absence of disease. Further investigation work is needed to analytically and clinically validate these imaging variables in order to identify potential imaging biomarkers in HS.

Electrodermal activity at acupoints: literature review and recommendations for reporting clinical trials

Electrodermal activity (EDA) at acupuncture points (acupoints) has been investigated for its utility as a diagnostic aid, a therapeutic monitoring tool, and a physiological outcome measure. The research methodologies reported in published trials, however, vary considerably and publications often lack sufficient details about electrical instrumentation, technical procedures, laboratory conditions, recorded measures, and control comparisons to permit a critical appraisal of the studies or to replicate promising findings. We developed a 10-category (54 subitems) Quality of Reporting scale based on technical issues associated with EDA measurements, publication requirements for reporting EDA in the psychophysiological literature, and recommendations from the CONSORT Statement for reporting clinical trials. Using our Quality of Reporting scale, we extracted data from 29 studies that evaluated EDA at acupoints in patients and generated weighted scores for each of the 10 categories of essential information. Only 9 of the 29 studies reviewed scored a mean of greater than 50% for reporting details of essential information. To rigorously build a program of research on EDA at acupoints we need to standardize research methodology and reporting protocols. We propose a checklist of recommended informational items to report in future clinical trials that record EDA at acupoints.

Lung meridian acupuncture point skin impedance in asthma and description of a mathematical relationship with FEV1

Alteration in acupoint skin impedance is purportedly associated with health impairment. This study examined lung meridian acupoint skin impedance in healthy individuals and patients with controlled asthma and the relationship if any with Forced Expiratory Volume in 1s (FEV(1)). Twenty-eight subjects diagnosed with asthma and 28 age and gender-matched healthy subjects had their FEV(1) and skin impedance, at acupoints LU 7 (Lieque) and LU 9 (Taiyuan) on the lung meridian, measured. Skin impedance was significantly higher in subjects with asthma (p<0.05) and negatively correlated with percent predicted FEV(1) (r=-0.34 to -0.40, p<0.005). The Receiver Operating Characteristic (ROC) suggested the cutoff point for logarithm-transformed mean of skin impedance for asthma was ≥3.59 unit (sensitivity=82.1%, specificity=82.1%) (AUC=0.878, p<0.001). A regression prediction equation of asthma was derived. This study suggests that acupoint skin impedance on the lung meridian may reflect the asthma condition. The use of skin impedance as an adjunctive, objective assessment in asthma screening and treatment monitoring, warrants further investigation.