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At least 433 records · Page 24Linked to original sources
PubMed2005

Digital image enhancement for in vivo laser scanning microscopy.

BACKGROUND/PURPOSE: In vivo confocal laser scanning microscopy (CLSM) is a new method that provides skin images in horizontal plane at a level of resolution that allows to view microanatomic structures. This study examines whether certain digital image-processing steps can increase the visibility of various structures in CLSM. STUDY DESIGN: Fifty images were taken from normal skin of 25 probands, and 39 image enhancement procedures were created. Eight procedures that seemed to provide some quality enhancement were deliberately selected for further evaluation. Subsequently, a collection of random pairs of the original image and an image submitted to any of the eight selected procedures was rated by five independent observers. RESULTS: In three of the eight procedures tested, the modified image was significantly preferred to the original image (chi2-test,: P< or =0.001). In particular, smoothing, shading correction, delineate and grey-level normalization in various combinations were helpful in showing the characteristic honeycomb pattern, pigmented basal cell layer, cell borders and the nuclei more clearly. CONCLUSION: Digital image processing may help to increase visibility of in vivo CLSM images.

Adolescent↗
PubMed2005

Fluorescence fibre-optic confocal microscopy of skin in vivo: microscope and fluorophores.

BACKGROUND/AIMS: Fibre-optic confocal imaging in vivo is a new approach in the assessment of human skin. The objective is to describe a novel instrument and its operation and use in combination with fluorophores. METHODS: The Stratum is a fibre-optic fluorescence confocal microscope especially developed for the study of skin and mucous membranes. The system is flexible and any body site can be studied with a hand-held scanner. The light source is a 488 nm argon ion laser. Horizontal (en face) images of the epidermis and outer dermis are produced with cellular resolution. Magnification is approximately 1000 x . Fluorescein sodium is routinely used as fluorophore (intradermal injection or application to the skin surface). This fluorophore is safe for human use in vivo, but other substances (rhodamine B, Acridine Orange, green fluorescent protein, curcumin) have also been studied. RESULTS: The instrument produces sharp images of epidermal cell layers from the epidermal surface to the sub-papillary dermis, with sub-cellular resolution. The scanner is flexible in use. The technique of intradermal fluorophore injection requires some skill. CONCLUSIONS: We consider this fibre-optic instrument a potentially important tool in skin research for non-invasive optical biopsy of primarily the epidermis. Present use is focussed on research applications, where the fluorophore distribution in the skin may illustrate morphological changes in the epidermis.

Dermoscopy↗
PubMed2006

Mid-infrared spectroscopy on skin using a silver halide fibre probe in vivo.

BACKGROUND/AIM: Mid-infrared spectroscopy is a versatile method for in vivo investigation of skin after topical treatment with skin care products. METHODS: FTIR-spectrometer (Bruker Optics) with a flexible silver halide fibre probe (Infrared Fiber Sensors). RESULTS: Absorbance spectra from 700 to 3000 cm(-1) have been recorded to gain information about proteins (amide-I and amide-II vibrations at 1650 and 1550 cm(-1)), esters (1740 cm(-1)), carboxylic acid (1710 cm(-1)), polyalcohols (1050 cm(-1)) and hydrocarbons (CH(n) vibrations at 2800-3000 cm(-1)). CONCLUSIONS: Using the particular light guide, we were able to measure for the first time the effects of lip care products on lips directly. Furthermore, water binding and glycerol content of the skin could be determined simultaneously, as well as the replenishment of lipids by lipid-enriched bath oil.

Adolescent↗
PubMed2006

Digital camera images obtained using a light-emitting diode illuminator and their dermatological applications.

BACKGROUND/PURPOSE: Although digital cameras have powerful macrocapabilities, flash macrophotographs are often unsatisfactory. The aim of this study was to develop a light-emitting diode (LED) illuminator for macro digital photography that allows colorimetric investigations of the skin. METHODS: We devised an LED illuminator suitable for acquiring super-macro digital images of the skin. Reference CIELAB color chart values were compared statistically with computed values from digital images in order to obtain equations for real CIELAB values. Using these, we acquired and analyzed images of various dermatological conditions using an LED illuminator. RESULTS: The images obtained with the devised LED illuminator were more reproducible than flash-assisted photographs. With proper camera settings, the devised LED illuminator and the color analysis method developed during this study provided digital skin images containing colorimetric information. CONCLUSION: A digital camera equipped with an LED illuminator is a useful tool for dermatological research and clinical practice.

Colorimetry↗
PubMed2006

High-resolution ultrasound reflex transmission imaging and digital photography: potential tools for the quantitative assessment of pigmented lesions.

BACKGROUND/AIMS: High-resolution ultrasound (HRU) is a relatively cheap imaging method that shows small quantitative differences between benign naevi and melanoma. Previous studies using B-mode display suggest that these arise from their differing attenuating properties. Attenuation characteristics, however, are better evaluated using reflex transmission imaging (RTI). White light clinical (WLC) photography is an even cheaper imaging method that is routinely used for monitoring but less frequently in everyday diagnosis. As features from each method may have an independent origin, two such modalities may be of greater diagnostic value than either method alone. However, although quantitative analysis of digital photographs is being developed to aid tumour diagnosis, in vivo RTI for the evaluation of pigmented skin lesions has not previously been described. This paper presents the feasibility of performing RTI in vivo and evaluates the reliability of the objective features used. The potential of the combination of quantitative RTI and white light (WL) digital photography data for the classification of pigmented lesions was assessed. METHODS: Randomly selected patients were recruited via a skin cancer screening clinic. RTI data were acquired from each index lesion with a 20 MHz single-element scanner. WL images were taken using a high-resolution (2.8 Mpixels) digital camera. Quantitative features calculated from both images were used to derive a discriminant rule. This equation was then applied to reclassify each case based on its quantitative criteria. The resultant classification was compared with histological diagnosis. RESULTS: Twenty-four lesions (10 melanoma and 14 naevi) were studied. On RTI, no subjective differences were observed between benign naevi and melanoma. Many lesions were either not visible on RTI or lacked clearly definable borders. Consequently, the WL photographs were used to draw lesion boundaries on RT images for feature calculation. Melanoma were less attenuating than naevi on RTI (P=0.026) and had greater red colour variegation on WL imaging (P=0.016). The combination of quantitative parameters (two from RTI and four from photographs) improved sensitivity for this sample without compromising the specificity of 100% compared with either modality alone. The procedure is highly reproducible (r=0.85 between two operators). CONCLUSIONS: Pigmented skin lesions can be quantitatively defined from RTI data acquired in vivo and a significant difference in attenuation is shown. However, accurate registration of the RT image with a corresponding photograph was crucial for this purpose and only possible when corresponding points could be reliably identified on both images. Combination of features from ultrasound and optical images may synergistically improve diagnostic accuracy and a larger study is warranted to investigate this.

Dermoscopy↗
PubMed2006

Sensitive skin: correlation with skin surface microrelief appearance.

BACKGROUND/PURPOSE: Sensitive skin is a condition associated with reduced tolerance to environmental factors and/or the application of topical products, such as cosmetics. Its pathophysiology has not been fully elucidated and few data are available on its prevalence. The aim of this study was to investigate possible correlation between objective sensitivity and skin surface microrelief. METHODS: During an epidemiological survey conducted for a campaign promoted by International Society of Plastic Dermatology in Italy, 243 adult healthy subjects of both sexes with no evident dermatological disorder but positive to the lactic acid stinging test, were submitted to cyanoacrylate stratum corneum stripping from the volar forearm for the determination of the irregularity of the skin surface microrelief (irregularity skin index (ISI)). RESULTS: A significant correlation was found between intensity of symptoms in stingers and ISI (r(s)=-0.47; P<0.001). CONCLUSION: Sensitive skin is common in the healthy population. ISI can contribute towards the identification of subjects with sensitive skin and the development of more specific skin treatments for this prevalent condition.

Adolescent↗
PubMed2006

Simulation and analysis of optical skin lesion images.

BACKGROUND/PURPOSE: In order to properly analyse the effectiveness of methods for optically differentiating malignant from benign skin lesions, it is necessary to have a set of images for which the ground truth is known. However, aspects of the ground truth of clinical images such as true lesion boundary position are unknown or not known precisely. Therefore, a skin/lesion image simulation with known features including boundary location, skin pattern and lesion colour is needed to enable accurate assessment of feature estimation algorithms for lesion classification. METHODS: In this paper, monochrome and colour skin/lesion images are synthesised with known characteristics including boundary, colour and skin pattern. Skin pattern is simulated with segmented lines with variations in length, orientation and intensity. Skin and lesion textures are modelled by an auto-regressive (AR) process. Monochrome skin lesion images are obtained by combining monochrome skin and lesion textures under the control of a known lesion shape with the addition of skin pattern. Colour skin lesion images are generated by mixing coloured skin and lesion textures. Finally, an inflammation area and image artefacts such as hair and specular reflection are added. RESULTS: The synthesised images provide the image set for evaluating image pre-processing, segmentation and skin pattern analysis. The pre-processing includes hair removal and specular reflection reduction. An AR model interpolation is suggested for hair removal, and multiple illumination processing is developed to decrease specular reflection. A fast snake algorithm is extended to detect the boundaries of skin lesion and inflammation areas. Skin line direction is detected as a feature to measure the disruption of skin pattern caused by lesion. CONCLUSIONS: Simulation of monochrome and colour skin/lesion image has been investigated, which is an alternative way to provide image set with known characteristics to validate image processing algorithms for image pre-processing, lesion/inflammation boundary detection and skin pattern analysis.

Colorimetry↗
PubMed2006

Evaluation of the epidermal refractive index measured by optical coherence tomography.

BACKGROUND/AIMS: It has recently been proposed that the refractive index (RI) measured by means of optical coherence tomography (OCT) may be a valid measure for hydration of skin. In this pilot study, using OCT in vivo, we aimed to investigate the interday variability of RI measurements and acute changes of RI following the application of a moisturizer. METHODS: Twenty healthy Caucasian volunteers were investigated on their forearms using a commercially available OCT system (SkinDex 300, ISIS optronics GmbH, Mannheim, Germany) fitted with an integrated algorithm for the evaluation of the RI. The interday repeatability of the OCT method was determined performing symmetrical measurements on both forearms on day 1, 5, 9, and 13. In order to investigate the acute effect of a moisturizer on RI, OCT assessments were performed before and 10 min after the application of an aqueous lotion with a lipophilic phase. As a control, the contralateral site was investigated in the same way, except for the use of distilled water instead of the lotion. RESULTS: Assessments of interday variability revealed insignificant (P>0.05) variances between the four measurement times as expressed in very small repeatability coefficients (right arm: 0.039; left arm 0.053) and small coefficients of variance (right arm: 1.02%; left arm: 1.38%). With regard to the RIs measured over time, we could not observe significant (P>0.05) differences between the two symmetrical anatomic sites (mean+/-SD of RI: 1.3893+/-0.0142 (right arm); 1.3875+/-0.0192 (left arm)). The acute effect of the moisturizer was indicated by a significant decrease of the RI 5 min after the application of the lotion (1.399+/-0.01 vs. 1.387+/-0.02; difference between means: 0.012; P=0.033; 95% confidence interval: 0.001-0.0023). However the control site treated with distilled water did not show significant differences between the two measurement times (1.387+/-0.013 vs. 1.391+/-0.023; difference between means: -0.004; P=0.57; 95% confidence interval: -0.019-0.011). CONCLUSIONS: In this pilot study, we have demonstrated that RI evaluation via OCT is a promising technique that may be used for the assessment of skin hydration in vivo. However, the direct comparison of OCT with standard methods, ideally such as nuclear magnetic resonance spectroscopy, is necessary.

Adult↗
PubMed2006

Phototrichogram findings in women with androgenetic alopecia.

BACKGROUND/PURPOSE: Androgenetic alopecia (AGA) in women is characterized by diffuse thinning in the frontal and parietal areas of the scalp; preservation of the frontal hairline is norm. Hair over the occipital scalp is preserved. The purpose of this work was to investigate the findings of phototrichogram (PTG) of the affected and the spared areas in women with AGA and to compare them with those of healthy subjects. METHODS: Twenty-two controls and 60 untreated women with AGA (32 with Ludwig I, 28 with Ludwig II) were included in this study. Hair density, percentages of thin hair, and non-growing hair were estimated both on the midscalp and on the occiput by using PTG with digital camera attached to a dermoscope. RESULTS: In the control group, hair density was higher on the midscalp than the occiput. In AGA groups, hair density was lower on the midscalp than the occiput and percentages of thin hair and non-growing hair were higher on the midscalp than the occiput. These findings were more prominent in Ludwig II group. In the occiput there were findings mimicking the changes seen on the midscalp. These were less striking than those seen on the midscalp yet the difference between the control and Ludwig II group was statistically significant. CONCLUSION: We concluded that the hair is not equally distributed on the scalp, the occiput may be affected in females with AGA and further studies are necessary to support these findings.

Adult↗
PubMed2006

In vivo imaging of intradermal tattoos by confocal scanning laser microscopy.

BACKGROUND/AIMS: In vivo confocal laser scanning microscopy (CLSM) is a new method for high-resolution imaging of intact skin in situ. Horizontal mapping of the outer skin is provided (magnification x 1000). OBJECTIVES: Tattooing is popular all over the world; however, tattooed skin has not been studied in using CLSM. RESULTS: Tattoos in two volunteers were studied using the Vivascope1500 of Lucid Inc. Subepidermal massive deposits of dense, clustered pigment granules up to about 3 mum in size corresponding to black tattoos, and more scarce and diffuse deposits, corresponding to red, blue and green tattoos, were observed. Diffuse pigment granules tended to accumulate in the outer dermis underneath the level of the basement membrane zone. CONCLUSIONS: Dermal pigments from tattoos can be imaged in vivo using CLSM. This application of CLSM has an important future potential for pre-evaluation of tattoos before laser removal, predicting good or poor outcome of laser removal.

Adult↗
PubMed2006

Validation of scalp coverage scoring methods for scalp hair loss in male pattern hair loss (androgenetic alopecia).

BACKGROUND: Global evaluation of hair loss in male subjects affected by androgenetic alopecia has been proposed as a means for monitoring changes over time, including placebo-controlled drug efficacy studies. Because of the potential impact of subjectivity (e.g. placebo effect) of clinical investigators, global photographs (GPs) have been introduced as a more objective record. Examination of paired before and after pictures and rating on a seven-point scale (from greatly decreased -3 to greatly increased +3) have been historically introduced by United States of America (US) experts. METHODS: Based on published GPs and original GPs obtained at our clinical research facility, we developed a training set in order to allow European Union (EU) observers to practice and compare with ratings by the US experts. RESULTS: After training with the seven-point scale, there was a positive correlation between three US and three EU ratings (n=52 paired images from 35 different subjects, r=0.795). The results of a test-retest evaluation was performed on 18 paired images from the initial image collection by the three EU experts. Correlation r=0.806 and identical scores in 78% of cases documents a reproducibility similar to the single one US expert published data (119 subjects, retest correlation 0.76 with 75% identical duplicate ratings). Seventeen subjects taken from a placebo-controlled trial had GPs at 6 and 12 months. The average difference between an efficacious drug treatment and the placebo were almost similar in the US (0.833) as in the EU (0.689) expert panels. We also trained the EU experts in performing the scalp coverage scoring (SCS), a novel system for the global evaluation of scalp hair in vivo and on GP. SCS was performed on single images (randomised as to time and treatment) taken from the same set of 17 paired GPs. This showed a between-group difference of 0.055 at 6 months and 0.201 at 12 months, i.e. 5% improved coverage in favour of the active group. CONCLUSION: After completion of our study, US and trained - calibrated EU experts seem equally valuable in comparing before-after GPs. SCS can also be used on GPs and may support the clinical investigator during inclusion of test subjects and for real-time efficacy evaluation during the trial.

Alopecia↗
PubMed2005

Recent findings with computerized methods for scalp hair growth measurements.

Sensitive tools have been developed in order to monitor hair loss and treatment responses. Recently the Tricho-Scan was presented (by RH) as such a method which combines epiluminescence microscopy (ELM) with automatic digital image analysis. Herewith new TrichoScan data obtained from 10 women and 21 men with androgenetic hair loss after 6 mo of treatment with 5%-minoxidil are presented. Even in this small cohort of patients, we noticed a significant increase of hair density, cumulative hair thickness and terminal hair counts. Alternative methods were developed during a human alopecia investigation and research technology (HAIR Technology) programme at Skinterface. This involves contrast-enhancement, image acquisition, and processing by qualified technicians followed by computer-assisted image analysis. The specific identification of exogen hair, further adds to this very refined non-invasive investigative method for hair follicle function investigation. Regional variations of hair growth dynamics do exist in the human scalp such as in female patients complaining of hair loss, scalp hair density and growth on top of the head differs significantly from the occipital site. Finally, from transversal studies and from detailed monitoring of subsequent hair cycles during longitudinal studies, data were obtained that support the fact that shortening of hair cycle, slowing down of growth rates and thinning of hair shafts are heralding hair miniaturisation. In the workshop the TrichoScan, the method of Canfield and Skinterface have been shown.

Adult↗
PubMed2006

Dermoscopic patterns of the filiform papillae of the tongue in patients with Sjögren's syndrome.

The purpose of this study was to determine whether there are any differences in the appearance of tongue-surface structure in different kinds of collagen diseases, because red tongue is well known to be a very important feature of suspected Sjögren's syndrome (Sjs). To clarify some features of the filiform papillae on the dorsal surfaces of the tongues of patients with speculated Sjs, we observed a total of 565 individuals with primary Sjs (n = 24, M/F = 0/24), secondary Sjs (n = 16, M/F = 1/15), possible Sjs (n = 96, M/F = 21/75), collagen diseases (CD) (n = 55, M/F = 15/40; 15 SSc, 10 SLE 10, two MCTD, six dermatomyositis, and 22 others), various cutaneous disorders (n = 324, M/F = 118/206), and healthy controls (HC) (n = 50, M/F = 32/18) by using a dermoscope. The average ages of the patients with Sjs, CD (non-Sjs), cutaneous disorders (non-Sjs/CD), and HC were 56.4 14.8, 55.1 116.4, 51.1 121.2, and 37.1 110.6 years of age, respectively. The filiform papillae were classified into four patterns by their structural characteristics: normal papillae (no abnormality with clear cornified tips) (pattern I, n = 162), slightly rounded papillae with unclear cornified tips (pattern II, n = 239), rounded papillae without cornified tips (pattern III, n = 86), and completely flattened papillae (pattern IV, n = 28). Their patterns were reversely related to the volume of salivary fluid (gum test) (P = 0.046) and the degree of furor coating of the tongue (P = 0.051). Pattern IV is predominant in definitive Sjs (primary and secondary Sjs) (n = 15; 53.6%) with positive anti-SS-A or -B antibody (n = 8) with a specificity of 53.6% and a sensitivity of 36.6%. The present dermoscopic finding that the completely flattened pattern (IV) is predominant in definite Sjs patients may indicate a useful marker for suspicion of Sjs.

Age Distribution↗
PubMed2004

One-year follow-up of a lentigo maligna: first dermoscopic signs of growth.

We report a 64-year-old man with a pigmented lesion on his forehead, initially thought to be actinic lentigo. At follow-up 1 year later the lesion had increased in size and showed new areas of pigmentation. Dermoscopic observation and biopsy led to a diagnosis of lentigo maligna and the lesion was excised. The dermoscopic features indicative of early growth of lentigo maligna are identified and discussed.

Dermoscopy↗