Pediatric morphea disease progression predicted with multispectral imaging
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Key takeaways:
- A multispectral 3D camera has shown benefits in predicting pediatric morphea disease progression.
- The Antera 3D camera illuminates the surface from different angles to digitally reconstruct the skin’s surface.
Multispectral imaging could provide promising accuracy in predicting progression of pediatric morphea, according to a study.
“Morphea can be progressive and debilitating, and a key prognostic factor is early introduction of potent anti-inflammatory therapy,” Cathal O’Connor, MD, of the department of dermatology at South Infirmary Victoria University Hospital and the INFANT Research Center at University College Cork, both in Ireland, and colleagues wrote. “Assessment of disease activity is difficult and distinction between early-inflamed lesions and late sclerotic lesions can lead to either undertreatment and therefore persistent disease, or overtreatment, with side effects from therapy potentially outweighing benefits.”
Researchers enrolled 17 children (average age, 12 years; age range, 6-18 years; 13 female; 16 white) with morphea, of whom 11 had linear morphea and six had plaque morphea.
Using the handheld portable Antera 3D camera (Miravex), which illuminated the surface from different angles to acquire images and uses the difference between images to digitally reconstruct the skin’s surface in three dimensions, multispectral images were collected from each subject. Images and follow-up visits were subsequently conducted every 3 months.
Hemoglobin variation differentials between affected skin and matched contralateral unaffected skin were evaluated at each visit to determine disease activity. Additionally, clinical assessment was completed using the Localized Scleroderma Assessment Tool (LoSCAT) and the DLQI.
An increase in at least two points or a relative increase of at least 20% on the LoSCAT activity index determined progression.
Average LoSCAT score at baseline was 20.6, the average activity component was 6.6 and the average damage score was 15.2, all of which fell into the moderate disease category.
Ten of the patients had progression of their morphea at least once during the study. During disease progression, the average hemoglobin gradient in these patients was four times higher in the affected vs. unaffected skin (average differential, 0.3) compared with patients who were not in disease progression (average differential, 0.8).
Multispectral imaging showed a sensitivity of 90% for detecting progression with a specificity of 100%.
“Morphea is a relatively uncommon dermatosis, but can be associated with significant morbidity, and is complicated by relatively poor methods for assessing disease activity. The lack of robust clinical tools to determine disease activity has recently been highlighted,” the authors wrote. “Multispectral imaging has the benefit of specifically examining the hemoglobin concentration in tissue, and when compared to matched contralateral tissue, can indicate local inflammation and therefore activity.”
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