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Li Y, Thng STG, Kong AWK. Bridging the Gap Between Vitiligo Segmentation and Clinical Scores. IEEE J Biomed Health Inform 2024; 28:1623-1634. [PMID: 38100337 DOI: 10.1109/jbhi.2023.3342069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Quantitative evaluation of vitiligo is crucial for assessing treatment response. Dermatologists evaluate vitiligo regularly to adjust their treatment plans, which requires extra work. Furthermore, the evaluations may not be objective due to inter- and intra-assessor variability. Though automatic vitiligo segmentation methods provide an objective evaluation, previous methods mainly focus on patch-wise images, and their results cannot be translated into clinical scores for treatment adjustment. Thus, full-body vitiligo segmentation needs to be developed for recording vitiligo changes in different body parts of a patient and for calculating the clinical scores. To bridge this gap, the first full-body vitiligo dataset with 1740 images, following the international vitiligo photo standard, was established. Compared with patch-wise images, full-body images have more complicated ambient light conditions and larger variances in lesion size and distribution. Additionally, in some hand and foot images, skin can be fully covered by either vitiligo or healthy skin. Previous patch-wise segmentation studies completely ignore these cases, as they assume that the contrast between vitiligo and healthy skin is available in each image for segmentation. To address the aforementioned challenges, the proposed algorithm in this study exploits a tailor-made contrast enhancement scheme and long-range comparison. Furthermore, a novel confidence score refinement module is proposed to manage images fully covered by vitiligo or healthy skin. Our results can be converted to clinical scores and used by clinicians. Compared to the state-of-the-art method, the proposed algorithm reduces the average per-image vitiligo involvement percentage error from 3.69% to 1.81%, and the top 10% per-image errors from 23.17% to 8.29%. Our algorithm achieves 1.17% and 3.11% for the mean and max error for the per-patient vitiligo involvement percentage, which is better than an experienced dermatologist's naked-eye evaluation.
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Dinish US, Yew YW, Vinod Ram K, Bi R, Attia ABE, Teo Xinhui V, Rajarahm P, Oon HH, Thng STG, Olivo M. Non-invasive biochemical analysis and comparison of atopic dermatitis and psoriasis skin using handheld confocal Raman spectroscopy. J Biophotonics 2023; 16:e202300191. [PMID: 37560963 DOI: 10.1002/jbio.202300191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/11/2023]
Abstract
A handheld non-invasive confocal Raman system (CRS) was used to evaluate the differences in skin biochemicals between atopic dermatitis (AD) and psoriasis, which are inflammatory skin conditions. Raman spectral measurements in the fingerprint and high wavenumber region were acquired using a portable in-house CRS system with excitation lasers operating at 671 and 785 nm. It was deduced that relative amount of water decreases in the following sequence of skin: healthy, psoriasis and AD. Moreover, differential trends were observed for the subclasses of ceramides such that ceramide 3 is lower in the lesional AD and psoriasis skin as compared to healthy, while ceramide 2 showed a contrasting trend of decrease in lesional AD and increase in lesional psoriasis as opposed to healthy skin. Amount of cholesterol was significantly higher in lesional psoriasis as compared to lesional AD and healthy skin. These differences can aid in an objective classification of the skin conditions and in the formulation of new disease-specific topical treatments.
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Affiliation(s)
- U S Dinish
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Yik Weng Yew
- National Skin Centre, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Keertana Vinod Ram
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Renzhe Bi
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Amalina Binte Ebrahim Attia
- Biomedical Research Council (BMRC), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Valerie Teo Xinhui
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Poongkulali Rajarahm
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Hazel Hweeboon Oon
- National Skin Centre and Skin Research Institute of Singapore (SRIS), Singapore, Singapore
| | | | - Malini Olivo
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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Yew YW, Mina T, Ng HK, Lam BCC, Riboli E, Lee ES, Lee J, Ngeow J, Elliott P, Thng STG, Chambers JC, Loh M. Investigating causal relationships between obesity and skin barrier function in a multi-ethnic Asian general population cohort. Int J Obes (Lond) 2023; 47:963-969. [PMID: 37479793 PMCID: PMC10511308 DOI: 10.1038/s41366-023-01343-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/23/2023] [Accepted: 07/05/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Skin diseases impact significantly on the quality of life and psychology of patients. Obesity has been observed as a risk factor for skin diseases. Skin epidermal barrier dysfunctions are typical manifestations across several dermatological disturbances. OBJECTIVES We aim to establish the association between obesity and skin physiology measurements and investigate whether obesity may play a possible causal role on skin barrier dysfunction. METHODS We investigated the relationship of obesity with skin physiology measurements, namely transepidermal water loss (TEWL), skin surface moisture and skin pH in an Asian population cohort (n = 9990). To assess for a possible causal association between body mass index (BMI) and skin physiology measurements, we performed Mendelian Randomization (MR), along with subsequent additional analyses to assess the potential causal impact of known socioeconomic and comorbidities of obesity on TEWL. RESULTS Every 1 kg/m2 increase in BMI was associated with a 0.221% (95%CI: 0.144-0.298) increase in TEWL (P = 2.82E-08), a 0.336% (95%CI: 0.148-0.524) decrease in skin moisture (P = 4.66E-04) and a 0.184% (95%CI: 0.144-0.224) decrease in pH (P = 1.36E-19), adjusting for age, gender, and ethnicity. Relationships for both TEWL and pH with BMI remained strong (Beta 0.354; 95%CI: 0.189-0.520 and Beta -0.170; 95%CI: -0.253 to -0.087, respectively) even after adjusting for known confounders, with MR experiments further supporting BMI's possible causal relationship with TEWL. Based on additional MR performed, none of the socioeconomic and comorbidities of obesity investigated are likely to have possible causal relationships with TEWL. CONCLUSION We establish strong association of BMI with TEWL and skin pH, with MR results suggestive of a possible causal relationship of obesity with TEWL. It emphasizes the potential impact of obesity on skin barrier function and therefore opportunity for primary prevention.
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Affiliation(s)
- Yik Weng Yew
- National Skin Centre, Singapore, 308205, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore
| | - Theresia Mina
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore
| | - Hong Kiat Ng
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore
| | - Benjamin Chih Chiang Lam
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore
- Khoo Teck Puat Hospital, Integrated Care for Obesity & Diabetes, Singapore, 768828, Singapore
| | - Elio Riboli
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1NY, United Kingdom
| | - Eng Sing Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore
- Clinical Research Unit, National Healthcare Group Polyclinic, Nexus@one-north, Singapore, 138543, Singapore
| | - Jimmy Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore
- Research Division, Institute of Mental Health, Singapore, 539747, Singapore
| | - Joanne Ngeow
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore
- Division of Medical Oncology, National Cancer Centre, Singapore, 169610, Singapore
| | - Paul Elliott
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1NY, United Kingdom
| | | | - John C Chambers
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1NY, United Kingdom
| | - Marie Loh
- National Skin Centre, Singapore, 308205, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, Singapore, 308232, Singapore.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1NY, United Kingdom.
- Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (A*STAR), Singapore, 138672, Singapore.
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Li X, Moothanchery M, Kwa CY, Tan WL, Yew YW, Thng STG, Dinish U, Attia ABE, Olivo M. Multispectral raster-scanning optoacoustic mesoscopy differentiate lesional from non-lesional atopic dermatitis skin using structural and functional imaging markers. Photoacoustics 2022; 28:100399. [PMID: 36090012 PMCID: PMC9450137 DOI: 10.1016/j.pacs.2022.100399] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 05/05/2023]
Abstract
Atopic dermatitis (AD) is a chronic and pruritic skin inflammatory disease causing a significant burden to health care management and patient's quality of life. Seemingly healthy skin or non-lesional sites on AD patients still presents skin barrier defects and immune response, which can develop to AD at a later stage. To investigate further the balance between the epidermal barrier impairment and intrinsic immune dysregulation in AD, we exploited multispectral Raster-Scanning Optoacoustic Mesoscopy (ms-RSOM) to image lesional and non-lesional skin areas on AD patients of different severities non-invasively to elucidate their structural features and functional information. Herein, we demonstrate the objective assessment of AD severity using relative changes in oxygen saturation (δsO2) levels in microvasculature along with other structural parameters such as relative changes in epidermis thickness (δET) and total blood volume (δTBV) between the lesional and non-lesional areas of the skin. We could observe an increasing trend for δsO2 and δTBV, which correlated well with the subjective clinical Scoring Atopic Dermatitis (SCORAD) for evaluating the severity. Notably, δET showed a decreasing trend with AD severity, indicating that the difference in epidermal thickness between lesional and non-lesional area of the skin decreases with AD severity. Our results also correlated well with conventional metrics such as trans-epidermal water loss (TEWL) and erythrosine sedimentation rate (ESR). We quantified the δsO2 and δET changes to objectively evaluate the treatment response before and four months after treatment using topical steroids and cyclosporine in one severe AD patient. We observed reduced δsO2 and δET post treatment. We envision that in future, functional and structural imaging metrics derived from ms-RSOM can be translated as objective markers to assess and stratify the severity of AD and understand the function of skin barrier dysfunctions and immune dysregulation. It could also be employed to monitor the treatment response of AD in regular clinical settings.
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Affiliation(s)
- Xiuting Li
- Translational Biophotonics Laboratory, Institute of Bioengineering and Bioimaging (IBB), Agency for Science, Technology and Research (A⁎STAR), Singapore
| | - Mohesh Moothanchery
- Translational Biophotonics Laboratory, Institute of Bioengineering and Bioimaging (IBB), Agency for Science, Technology and Research (A⁎STAR), Singapore
| | | | | | | | | | - U.S. Dinish
- Translational Biophotonics Laboratory, Institute of Bioengineering and Bioimaging (IBB), Agency for Science, Technology and Research (A⁎STAR), Singapore
- Corresponding authors.
| | - Amalina Binte Ebrahim Attia
- Translational Biophotonics Laboratory, Institute of Bioengineering and Bioimaging (IBB), Agency for Science, Technology and Research (A⁎STAR), Singapore
- Corresponding authors.
| | - Malini Olivo
- Translational Biophotonics Laboratory, Institute of Bioengineering and Bioimaging (IBB), Agency for Science, Technology and Research (A⁎STAR), Singapore
- Corresponding authors.
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Park S, Saw SN, Li X, Paknezhad M, Coppola D, Dinish US, Ebrahim Attia AB, Yew YW, Guan Thng ST, Lee HK, Olivo M. Model learning analysis of 3D optoacoustic mesoscopy images for the classification of atopic dermatitis. Biomed Opt Express 2021; 12:3671-3683. [PMID: 34221687 PMCID: PMC8221944 DOI: 10.1364/boe.415105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/15/2021] [Accepted: 03/09/2021] [Indexed: 05/07/2023]
Abstract
Atopic dermatitis (AD) is a skin inflammatory disease affecting 10% of the population worldwide. Raster-scanning optoacoustic mesoscopy (RSOM) has recently shown promise in dermatological imaging. We conducted a comprehensive analysis using three machine-learning models, random forest (RF), support vector machine (SVM), and convolutional neural network (CNN) for classifying healthy versus AD conditions, and sub-classifying different AD severities using RSOM images and clinical information. CNN model successfully differentiates healthy from AD patients with 97% accuracy. With limited data, RF achieved 65% accuracy in sub-classifying AD patients into mild versus moderate-severe cases. Identification of disease severities is vital in managing AD treatment.
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Affiliation(s)
- Sojeong Park
- Bioinformatics Institute, Agency of Science, Technology and Research, ASTAR, 30 Biopolis Street, #07-01 Matrix, 138671, Singapore
- Co-first authors
| | - Shier Nee Saw
- Bioinformatics Institute, Agency of Science, Technology and Research, ASTAR, 30 Biopolis Street, #07-01 Matrix, 138671, Singapore
- Current address: Department of Artificial Intelligence, Faculty of Computer Science and Information Technology, University of Malaya, Malaysia
- Co-first authors
| | - Xiuting Li
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, ASTAR, 11 Biopolis Way, 138667, Singapore
- Co-first authors
| | - Mahsa Paknezhad
- Bioinformatics Institute, Agency of Science, Technology and Research, ASTAR, 30 Biopolis Street, #07-01 Matrix, 138671, Singapore
| | - Davide Coppola
- Bioinformatics Institute, Agency of Science, Technology and Research, ASTAR, 30 Biopolis Street, #07-01 Matrix, 138671, Singapore
| | - U S Dinish
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, ASTAR, 11 Biopolis Way, 138667, Singapore
| | | | - Yik Weng Yew
- National Skin Centre, 1 Mandalay, 308205, Singapore
| | | | - Hwee Kuan Lee
- Bioinformatics Institute, Agency of Science, Technology and Research, ASTAR, 30 Biopolis Street, #07-01 Matrix, 138671, Singapore
- School of Computing, National University of Singapore, 13 Computing Drive, Singapore, 117417, Singapore
- Singapore Eye Research Institute (SERI), 11 Third Hospital Ave, Singapore, 168751, Singapore
- Image and Pervasive Access Laboratory (IPAL), 1 Fusionopolis Way, #21-01 Connexis (South Tower), 138632, Singapore
- Rehabilitation Research Institute of Singapore, 11 Mandalay Road #14-03, Clinical Sciences Building, 308232, Singapore
| | - Malini Olivo
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, ASTAR, 11 Biopolis Way, 138667, Singapore
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Attia ABE, Moothanchery M, Li X, Yew YW, Thng STG, Dinish U, Olivo M. Microvascular imaging and monitoring of hemodynamic changes in the skin during arterial-venous occlusion using multispectral raster-scanning optoacoustic mesoscopy. Photoacoustics 2021; 22:100268. [PMID: 34026491 PMCID: PMC8122174 DOI: 10.1016/j.pacs.2021.100268] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 05/18/2023]
Abstract
The ability to monitor oxygen delivery in microvasculature plays a vital role in measuring the viability of skin tissue and the probability of recovery. Using currently available clinical imaging tools, it is difficult to observe non-invasive hemodynamic regulation in the peripheral vessels. Here we propose the use of a novel multispectral raster-scanning optoacoustic mesoscopy (RSOM) system for noninvasive clinical monitoring of hemodynamic changes in the skin microvasculature's oxy- (HbO2) and deoxy-hemoglobin (Hb), total hemoglobin (HbT) and oxygen saturation (rsO2). High resolution images of hemoglobin distribution in the skin microvasculature from six healthy volunteers during venous and arterial occlusion, simulating systemic vascular diseases are presented. During venous occlusion, Hb and HbO2 optoacoustic signals showed an increasing trend with time, followed by a drop in the values after cuff deflation. During arterial occlusion, an increase in Hb value and decrease in HbO2 values was observed, followed by a drop in Hb and jump in HbO2 values after the cuff deflation. A decrease in rsO2 values during both venous and arterial occlusion was observed with an increase in value after occlusion release. Using this proof of concept study, hereby we propose multispectral RSOM as a novel tool to measure high resolution hemodynamic changes in microvasculature for investigating systemic vascular diseases on peripheral tissues and also for monitoring inflammatory skin diseases, and its therapeutic interventions.
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Affiliation(s)
- Amalina Binte Ebrahim Attia
- Laboratory of Bio Optical Imaging, Singapore Bioimaging Consortium, Agency of Science, Technology and Research (A*STAR), Singapore
| | - Mohesh Moothanchery
- Laboratory of Bio Optical Imaging, Singapore Bioimaging Consortium, Agency of Science, Technology and Research (A*STAR), Singapore
| | - Xiuting Li
- Laboratory of Bio Optical Imaging, Singapore Bioimaging Consortium, Agency of Science, Technology and Research (A*STAR), Singapore
| | | | | | - U.S. Dinish
- Laboratory of Bio Optical Imaging, Singapore Bioimaging Consortium, Agency of Science, Technology and Research (A*STAR), Singapore
- Corresponding authors.
| | - Malini Olivo
- Laboratory of Bio Optical Imaging, Singapore Bioimaging Consortium, Agency of Science, Technology and Research (A*STAR), Singapore
- Corresponding authors.
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Yew YW, Unnimadhava Kurup Soudamini Amma D, Kuan AHY, Li X, Dev K, Ebrahim Attia AB, Bi R, Moothanchery M, Balasundaram G, Aguirre J, Ntziachristos V, Olivo M, Thng STG. Raster-scanning optoacoustic mesoscopy imaging as an objective disease severity tool in atopic dermatitis patients. J Am Acad Dermatol 2020; 84:1121-1123. [PMID: 32561371 DOI: 10.1016/j.jaad.2020.06.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 05/14/2020] [Accepted: 06/06/2020] [Indexed: 11/18/2022]
Affiliation(s)
| | | | | | - Xiuting Li
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A∗STAR), Singapore
| | - Kapil Dev
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A∗STAR), Singapore
| | - Amalina Binte Ebrahim Attia
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A∗STAR), Singapore
| | - Renzhe Bi
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A∗STAR), Singapore
| | - Mohesh Moothanchery
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A∗STAR), Singapore
| | - Ghayathri Balasundaram
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A∗STAR), Singapore
| | - Juan Aguirre
- Munich School of Bioengineering, Technische Universität München, Munich, Germany
| | - Vasilis Ntziachristos
- Munich School of Bioengineering, Technische Universität München, Munich, Germany; Helmholtz Zentrum München, Institute for Biological and Medical Imaging, Munich, Germany
| | - Malini Olivo
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A∗STAR), Singapore
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Ho CJH, Yew YW, Dinish US, Kuan AHY, Wong MKW, Bi R, Dev K, Li X, Singh G, Moothanchery M, Perumal J, Thng STG, Olivo M. Handheld confocal Raman spectroscopy (CRS) for objective assessment of skin barrier function and stratification of severity in atopic dermatitis (AD) patients. J Dermatol Sci 2020; 98:20-25. [PMID: 32063461 DOI: 10.1016/j.jdermsci.2020.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/27/2020] [Accepted: 02/01/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND We developed the first-of-its-kind handheld confocal Raman spectroscopy (CRS) system to quantify the concentration of natural moisturizing factors in the skin. OBJECTIVE To evaluate the feasibility of our handheld CRS system and propose a novel quantitative index to measure skin barrier function. METHODS This prospective study included 30 atopic dermatitis (AD) patients and 14 healthy volunteers. All AD participants were assessed using the Scoring Atopic Dermatitis (SCORAD) severity instrument, a vapometer for trans-epidermal water loss and a moisture meter for skin surface moisture. A handheld CRS operating at 785 nm laser was used to measure the biochemical constituents of the skin up to a depth of ∼100 μm. We trained a linear kernel-based support vector machine (SVM) model for eczema classification based on the water, ceramide and urocanic acid content. A novel Eczema Biochemical Index (EBI) was then formulated using the skin constituents measured from the AD participants to stage disease severity. RESULTS The SVM model used to classify healthy participants and AD patients obtained high cross-validated area under the curve of 0.857 and accuracy of 0.841, with high sensitivity and specificity values of 0.857 and 0.833 respectively. EBI can be used to stratify AD patients of varying severity, based on the biochemical constituents in the skin. CONCLUSION As compared to the standard CRS system, the handheld CRS offers higher portability and provides Raman measurements at various body regions with similar sensitivity. This suggests that a handheld CRS device could be a valuable point-of-care resource in both research and clinical use.
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Affiliation(s)
- Chris Jun Hui Ho
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | | | - U S Dinish
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | | | - Melvin Kai Weng Wong
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Renzhe Bi
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Kapil Dev
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Xiuting Li
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Gurpreet Singh
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Mohesh Moothanchery
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Jayakumar Perumal
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | | | - Malini Olivo
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
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Toh JJH, Chuah SY, Jhingan A, Chong WS, Thng STG. Afamelanotide implants and narrow-band ultraviolet B phototherapy for the treatment of nonsegmental vitiligo in Asians. J Am Acad Dermatol 2020; 82:1517-1519. [PMID: 31987791 DOI: 10.1016/j.jaad.2020.01.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 10/25/2022]
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10
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Lim ZV, Akram F, Ngo CP, Winarto AA, Lee WQ, Liang K, Oon HH, Thng STG, Lee HK. Automated grading of acne vulgaris by deep learning with convolutional neural networks. Skin Res Technol 2019; 26:187-192. [DOI: 10.1111/srt.12794] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 09/05/2019] [Indexed: 12/25/2022]
Affiliation(s)
| | - Farhan Akram
- Bioinformatics Institute Agency for Science, Technology and Research (A*STAR) Singapore Singapore
| | - Cuong Phuc Ngo
- Bioinformatics Institute Agency for Science, Technology and Research (A*STAR) Singapore Singapore
- Hwa Chong Institution Singapore Singapore
| | - Amadeus Aristo Winarto
- Bioinformatics Institute Agency for Science, Technology and Research (A*STAR) Singapore Singapore
- Hwa Chong Institution Singapore Singapore
| | - Wei Qing Lee
- School of Computing National University of Singapore Singapore Singapore
| | - Kaicheng Liang
- Bioinformatics Institute Agency for Science, Technology and Research (A*STAR) Singapore Singapore
| | | | - Steven Tien Guan Thng
- National Skin Centre Singapore Singapore
- Skin Research Institute Singapore A*STAR Singapore Singapore
| | - Hwee Kuan Lee
- Bioinformatics Institute Agency for Science, Technology and Research (A*STAR) Singapore Singapore
- School of Computing National University of Singapore Singapore Singapore
- Image and Pervasive Access Lab CNRS Singapore Singapore
- Singapore Eye Research Institute Singapore Singapore
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Nguyen S, Chuah SY, Fontas E, Khemis A, Jhingan A, Thng STG, Passeron T. Atorvastatin in Combination With Narrowband UV-B in Adult Patients With Active Vitiligo: A Randomized Clinical Trial. JAMA Dermatol 2019; 154:725-726. [PMID: 29617528 DOI: 10.1001/jamadermatol.2017.6401] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Sophie Nguyen
- Department of Dermatology, Université Côte d'Azur, Centre Hospitalier Universitaire Nice, Nice, France
| | | | - Eric Fontas
- Department of Clinical Research and Innovation, Université Côte d'Azur, Centre Hospitalier Universitaire Nice, Nice, France
| | - Abdallah Khemis
- Department of Dermatology, Université Côte d'Azur, Centre Hospitalier Universitaire Nice, Nice, France
| | | | | | - Thierry Passeron
- Department of Dermatology, Université Côte d'Azur, Centre Hospitalier Universitaire Nice, Nice, France.,Université Côte d'Azur, INSERM U1065, team 12, C3M, Nice, France
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Li X, Dinish US, Aguirre J, Bi R, Dev K, Attia ABE, Nitkunanantharajah S, Lim QH, Schwarz M, Yew YW, Thng STG, Ntziachristos V, Olivo M. Optoacoustic mesoscopy analysis and quantitative estimation of specific imaging metrics in Fitzpatrick skin phototypes II to V. J Biophotonics 2019; 12:e201800442. [PMID: 31012286 DOI: 10.1002/jbio.201800442] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/12/2019] [Accepted: 04/22/2019] [Indexed: 05/07/2023]
Abstract
Raster Scanning Optoacoustic Mesoscopy (RSOM) is a novel optoacoustic imaging modality that offers non-invasive, label-free, high resolution (~7 μm axial, ~30 μm lateral) imaging up to 1 to 2 mm below the skin, providing novel quantitative insights into skin pathophysiology. As the RSOM image contrast mechanism is based on light absorption, it is expected that the amount of melanin present in the skin will affect RSOM images. However, the effect of skin tone in the performance of RSOM has not been addressed so far. Herein, we present the efficiency of RSOM for in vivo skin imaging of human subjects with Fitzpatrick (FP) skin types between II to V. RSOM images acquired from the volar forearms of the subjects were used to derive metrics used in RSOM studies, such as total blood volume, vessel diameter and melanin signal intensity. Our study shows that the melanin signal intensity derived from the RSOM images exhibited an excellent correlation with that obtained from a clinical colorimeter for the subjects of varying FP skin types. We could successfully estimate the vessel diameter at different depths of the dermis. Furthermore, our study shows that there is a need to compensate for total blood volume calculated for subjects with higher FP skin types due to the lower signal-to-noise ratio in dermis, owing to strong absorption of light by melanin. This study sheds light into how RSOM can be used for studying various skin conditions in populations with different skin phenotypes.
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Affiliation(s)
- Xiuting Li
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - U S Dinish
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | | | - Renzhe Bi
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Kapil Dev
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Amalina Binte Ebrahim Attia
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | | | - Qian Han Lim
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | | | | | | | - Vasilis Ntziachristos
- Technical University of Munich, Munich, Germany
- Institute for Biological and Medical Imaging, Helmholtz Zentrum München, Neuherberg, Germany
| | - Malini Olivo
- Laboratory of Bio-Optical Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
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Yew YW, Dinish US, Choi ECE, Bi R, Ho CJH, Dev K, Li X, Attia ABE, Wong MKW, Balasundaram G, Ntziachristos V, Olivo M, Thng STG. Investigation of morphological, vascular and biochemical changes in the skin of an atopic dermatitis (AD) patient in response to dupilumab using raster scanning optoacoustic mesoscopy (RSOM) and handheld confocal Raman spectroscopy (CRS). J Dermatol Sci 2019; 95:123-125. [PMID: 31558224 DOI: 10.1016/j.jdermsci.2019.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 11/16/2022]
Affiliation(s)
| | - U S Dinish
- Laboratory of Bio-Optical Imging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A⁎STAR), Singapore
| | | | - Renzhe Bi
- Laboratory of Bio-Optical Imging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A⁎STAR), Singapore
| | - Chris Jun Hui Ho
- Laboratory of Bio-Optical Imging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A⁎STAR), Singapore
| | - Kapil Dev
- Laboratory of Bio-Optical Imging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A⁎STAR), Singapore
| | - Xiuting Li
- Laboratory of Bio-Optical Imging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A⁎STAR), Singapore
| | - Amalina Binte Ebrahim Attia
- Laboratory of Bio-Optical Imging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A⁎STAR), Singapore
| | - Melvin Kai Weng Wong
- Laboratory of Bio-Optical Imging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A⁎STAR), Singapore
| | - Ghayathri Balasundaram
- Laboratory of Bio-Optical Imging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A⁎STAR), Singapore
| | - Vasilis Ntziachristos
- Munich School of Bioengineering, Technische Universität München, Germany; Helmholtz Zentrum München, Institute for Biological and Medical Imaging, Germany
| | - Malini Olivo
- Laboratory of Bio-Optical Imging, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A⁎STAR), Singapore
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Chuah SY, Attia ABE, Ho CJH, Li X, Lee JSS, Tan MWP, Yong AA, Tan AWM, Razansky D, Olivo M, Thng STG. Volumetric Multispectral Optoacoustic Tomography for 3-Dimensional Reconstruction of Skin Tumors: A Further Evaluation with Histopathologic Correlation. J Invest Dermatol 2019; 139:481-485. [DOI: 10.1016/j.jid.2018.08.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
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Abstract
Abnormally high production of melanin or melanogenesis in skin melanocytes results in hyperpigmentation disorders, such as melasma, senile lentigines or freckles. These hyperpigmentary skin disorders can significantly impact an individual's appearance, and may cause emotional and psychological distress and reduced quality of life. A large number of melanogenesis inhibitors have been developed, but most have unwanted side-effects. Further research is needed to better understand the mechanisms of hyperpigmentary skin disorders and to develop potent and safe inhibitors of melanogenesis. This review summarizes the current understanding of melanogenesis regulatory pathways, the potential involvement of the immune system, various drugs in current use, and emerging treatment strategies to suppress melanogenesis.
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Affiliation(s)
- Sulekha Kumari
- Institute of Genomics and Integrative Biology, Council for Scientific and Industrial Research, New Delhi, India
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16
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Chuah SY, Thng STG. The role of in vivo reflectance confocal microscopy in assessing the stability of vitiligo vulgaris prior to cellular grafting. Skin Res Technol 2018; 25:245-247. [DOI: 10.1111/srt.12638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 09/24/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Sai Yee Chuah
- Department of DermatologyNational Skin Centre Singapore Singapore
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17
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Toh JJH, Bhoi S, Tan VWD, Chuah SY, Jhingan A, Kong AWK, Thng STG. Automated scoring of vitiligo using superpixel-generated computerized digital image analysis of clinical photographs: a novel and consistent way to score vitiligo. Br J Dermatol 2018; 179:220-221. [PMID: 29573393 DOI: 10.1111/bjd.16563] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J J H Toh
- Dermatology, National Skin Centre, 1 Mandalay Road, Singapore, 308205, Singapore
| | - S Bhoi
- Nanyang Technological University, School of Science and Computer Engineering, Singapore, Singapore
| | - V W D Tan
- Research, National Skin Centre, 1 Mandalay Road, Singapore, 308205, Singapore
| | - S Y Chuah
- Dermatology, National Skin Centre, 1 Mandalay Road, Singapore, 308205, Singapore
| | - A Jhingan
- Dermatology, National Skin Centre, 1 Mandalay Road, Singapore, 308205, Singapore
| | - A W K Kong
- Nanyang Technological University, School of Science and Computer Engineering, Singapore, Singapore
| | - S T G Thng
- Dermatology, National Skin Centre, 1 Mandalay Road, Singapore, 308205, Singapore
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18
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Cheng HM, Chuah SY, Gan EY, Jhingan A, Thng STG. A retrospective clinico-pathological study comparing lichen planus pigmentosus with ashy dermatosis. Australas J Dermatol 2018; 59:322-327. [PMID: 29635779 DOI: 10.1111/ajd.12813] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 02/10/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND/OBJECTIVES Controversy persists as to whether lichen planus pigmentosus and ashy dermatosis are separate clinical entities. This study was conducted to examine the clinicopathological features and treatment outcome of the two conditions. METHODS A retrospective medical chart review of all patients who were diagnosed with lichen planus pigmentosus or ashy dermatosis was conducted. The information collected included the participants' age at onset, site of onset, duration of disease, presence of precipitating factors, distribution of disease, pigmentation and presence of symptoms. In patients from whom a biopsy was taken the histopathological reports were included. RESULTS Altogether 26 patients with ashy dermatosis and 29 with lichen planus pigmentosus were included in the study. Compared with ashy dermatosis, lichen planus pigmentosus had a more localised distribution with a preponderance for facial involvement, compared with the truncal preponderance in ashy dermatosis. Ashy dermatosis tended to have a more stable clinical course than lichen planus pigmentosus, which was more likely to wax and wane. The utility of histopathology in differentiating between the two conditions is low. CONCLUSION Ashy dermatosis and lichen planus pigmentosus, as defined in this study, appear to be two separate clinical entities with distinguishable clinical features and natural histories.
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Affiliation(s)
- Hui Mei Cheng
- Department of Dermatology, National Skin Centre, Singapore City, Singapore
| | - Sai Yee Chuah
- Department of Dermatology, National Skin Centre, Singapore City, Singapore
| | - Emily Yiping Gan
- Department of Dermatology, National Skin Centre, Singapore City, Singapore
| | - Anjali Jhingan
- Department of Dermatology, National Skin Centre, Singapore City, Singapore
| | - Steven Tien Guan Thng
- Department of Dermatology, National Skin Centre, Singapore City, Singapore.,Department of Material Science and Engineering, Nanyang Technological University, Singapore City, Singapore
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Attia ABE, Chuah SY, Razansky D, Ho CJH, Malempati P, Dinish U, Bi R, Fu CY, Ford SJ, Lee JSS, Tan MWP, Olivo M, Thng STG. Noninvasive real-time characterization of non-melanoma skin cancers with handheld optoacoustic probes. Photoacoustics 2017; 7:20-26. [PMID: 28652976 PMCID: PMC5473546 DOI: 10.1016/j.pacs.2017.05.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 05/11/2017] [Accepted: 05/30/2017] [Indexed: 05/05/2023]
Abstract
Currently, imaging technologies that enable dermsurgeons to visualize non-melanoma skin cancers (NMSC) in vivo preoperatively are lacking, resulting in excessive or incomplete removal. Multispectral optoacoustic tomography (MSOT) is a volumetric imaging tool to differentiate tissue chromophores and exogenous contrast agents, based on differences in their spectral signatures and used for high-resolution imaging of functional and molecular contrast at centimeter scale depth. We performed MSOT imaging with two- and three-dimensional handheld scanners on 21 Asian patients with NMSC. The tumors and their oxygenation parameters could be distinguished from normal skin endogenously. The lesion dimensions and depths were extracted from the spectral melanin component with three-dimensional spatial resolution up to 80 μm. The intraclass correlation coefficient correlating tumor dimension measurements between MSOT and ex vivo histology of excised tumors, showed good correlation. Real-time 3D imaging was found to provide information on lesion morphology and its underlying neovasculature, indicators of the tumor's aggressiveness.
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Affiliation(s)
| | | | - Daniel Razansky
- Institute for Biological and Medical Imaging, Technical University of Munich and Helmholtz Center Munich, Germany
- Corresponding authors.
| | - Chris Jun Hui Ho
- Bio-optical Imaging Group, Singapore Bioimaging Consortium, A*STAR, Singapore
| | - Pinky Malempati
- Bio-optical Imaging Group, Singapore Bioimaging Consortium, A*STAR, Singapore
| | - U.S. Dinish
- Bio-optical Imaging Group, Singapore Bioimaging Consortium, A*STAR, Singapore
| | - Renzhe Bi
- Bio-optical Imaging Group, Singapore Bioimaging Consortium, A*STAR, Singapore
| | - Chit Yaw Fu
- Bio-optical Imaging Group, Singapore Bioimaging Consortium, A*STAR, Singapore
| | | | | | | | - Malini Olivo
- Bio-optical Imaging Group, Singapore Bioimaging Consortium, A*STAR, Singapore
- Corresponding authors.
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Cheng HM, Thng STG, Tan WP, Chuah SY. Handheld reflectance confocal microscopy: A useful tool to aid diagnosis of acral pigmented lesions. J Dermatol 2016; 43:980-1. [DOI: 10.1111/1346-8138.13322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 01/06/2016] [Indexed: 11/28/2022]
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Ng PPL, Thng STG. Three cases of transition from pemphigus vulgaris to pemphigus foliaceus confirmed by desmoglein ELISA. Dermatology 2005; 210:319-21. [PMID: 15942219 DOI: 10.1159/000084757] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2003] [Accepted: 08/20/2004] [Indexed: 11/19/2022] Open
Abstract
We report 3 cases of pemphigus vulgaris (PV) confirmed by histology and direct and indirect immunofluorescence that showed transition to pemphigus foliaceus (PF) 2-4 years from the time of disease onset. Desmoglein (Dsg) ELISA testing of the sera from these 3 patients in the later stages of their disease showed the presence of anti-Dsg1 antibodies and the absence of anti-Dsg3 antibodies. These patients were on prednisolone and immunosuppressives at the time the sera were tested, and it is unclear if the transition from PV to PF is a permanent one or whether it is due to preferential suppression of Dsg3 antibodies below a certain threshold. Previously reported cases of transition from PV to PF and PF to PV are summarized.
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