Noninvasive surface imaging.ppt [โหมดความเข้ากันได้] surface imaging.pdf · 1 Noninvasive Surface Imaging Supenya Varothai, M.D. Department of

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Noninvasive Surface Imaging

Supenya Varothai, M.D.Department of Dermatology,Faculty of Medicine Siriraj Hospital,Mahidol University

Researches in Dermatology

Studies in change of skinSkin biopsy, special stain invasiveSubjective scoring systems qualitative

Noninvasive techniqueObjective measurementQuantification

Skin Bioengineering

Skin BioengineeringDefinition

Biophysical methods for noninvasivequantification of the qstructures and functions of diseased, abnormal and normal skin

Advantages– Noninvasive– Quantitative (objective) measurement– Multiple measurement

Multi disciplinary

Skin Bioengineering

– Multi-disciplinary

Skin Bioengineering

TEWA meter

Skin pH meterCorneometer

ApplicationsSkin barrier functionSkin pHCutaneous hydration

MexameterCutometer

Visiometer, visioscan

hydrationSkin colorSkin biomechanical propertiesSkin surface imaging

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Skin Surface Appearance

Background

Human perception based on visualization of surfaceOuter most skin = stratum corneum (SC)Physical state of SC often reflects changes

d b l bloccurred below in viable tissues

Skin Surface Appearance

– Acanthosis– Atrophy– Post Inflammation

Epidermal pigment

Examples– Thickening– Thinning– Scaling

Brown – Epidermal pigment

– Dermal pigment– Hyperkeratosis

– Brown pigmentation

– Blue pigmentation– Rough, dry,

cracked

Factors Defines Skin Surface Appearance

TextureMicroreliefWrinklesScaling

PigmentBlood flowScalingSurface lipid

Color Physiologic properties

Skin elasticityPliability of SCSweat productionSebum productionSkin temperature

Factors Defines Skin Surface Appearance

TextureMicroreliefWrinklesScaling

PigmentBlood flowScalingSurface lipid

Color Physiologic properties

Skin elasticityPliability of SCSweat productionSebum productionSkin temperature

Microrelief (Glyphic pattern)

Genetically determinedPatterns: loops, whorls and arches on the fingertips

Palms & soles: dermatoglyphics

arches on the fingertipsIrregular criss-crossed by straight or slightly curved, deeper lines on the palms

Useful in studying chromosomal abberation and skin disorders

รูปลายมือ

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Microrelief (Glyphic pattern)

Palms & soles: dermatoglyphics

Microrelief (Glyphic pattern)

Genetically determinedGlabrous skin: furrows that cross each others to form squares, rectangles, trapezoidsMorphology of skin lines related to dermal elastic networkGood indicator for skin aging process

Microrelief (Glyphic pattern)

Functions of linesRetention and drainage canals of sebum & sweat and topically applied substances preferential sites of ppercutaneous absorption (reservoir)

Mechanical results from decrease of collagen elasticity along tension of skin (Langer’s line)

Microrelief (Glyphic pattern)

Primary line: parallel, 20-100 μm in depthAlways longer, broader, deeperForm in superficial dermis, related with elastic network

Secondary line5-40 μm in depthForm diagonal with primary lines triangles, rhomboids, trapezoidsEpidermic orgin

Microrelief (Glyphic pattern)Microrelief patterns

Primary lines

Secondary lines

Microrelief pattern

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Microrelief (Glyphic pattern)

Tertiary lineBoundary of corneocytes, 0.5 μm in depth

Quaternary lineSurface marking on individual corneocytes, g y ,0.05 μm in depth

Tertiary lines

Microrelief (Glyphic pattern)

Quaternary line

Microrelief (Glyphic pattern)

Difference in microrelief patternBody siteAge

Incresed and prominent primary linesDecreased fine lines

Skin diseases

รูปผิวเด็ก รูปผิวคนแก

20 years old 50 years old

WrinklesAcquired after adult lifeReflecting deterioration of the dermal matrix: loss of elasticityLoss of collagen and clumping of degraded elastic fiber in amorphous massAppears in the direction of skin tensionAppears in the direction of skin tensionResult of both intrisic and extrinsic aging

Scaling

Scales= corneocyte aggregation that break from the skin surface Many variety of scaling– Diseases of abnormal keratinization:

PsoriasisIchthyosis vulgarisPityriasis versicolor

– Ordinary dry skin: Most common formXerotic vulgaris, winter xerosis

Scaling

Enzymatic degradation of corneodesmosome

Corneocyte desquamation process

Hydrolytic enzymes require high

water activity

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Scaling

Shedding of “Clumps” of corniocytesNormal shedding

Flakes or Scales

Factors Influence on Skin RoughnessPhysiological factors

Water content (hydrolipidic barrier)Body siteAgeSkin diseases and internal diseasesHealing of wounds and scars

Environmental factorsUV radiation LifestylePharmaceuticals and cosmetic productsAir humidity and temperature (Season and climate)

Skin Texture Measurement

Skin texture measurement

“Surface contour and roughness assessment”

1. Indirect assessment of skin replication

2. In vivo direct measurement of the skin

Indirect assessment of skin replication– Skin replication by

Carbon and metal/carbon Plastic impression techniqueSilicone elastomer replication

Skin texture measurement

Silicone elastomer replicationdental impression material

Skin Replication

Negative replica

Positive replica

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Skin Replication

Silicone replica capture pore refinement at baseline and eight week

Indirect assessment of skin replication

1. Profilometry (stylus method)M h i l

Skin texture measurement

– Mechanical– Optical

2. Image analysis

Mechanical stylus

Conventional methodA stylus traversed across the replica surface

Vertical displacement of stylus

Digital signals

Computerized analysis of skin roughness

Mechanical stylus

Skin replica before and after 3 wks after therapy

Mechanical stylus

LimitationsDirect contact to the skin pressure of the spheric head crates deformation of skin surfaceSlow data acquisition: very slow scanning speed (2 hr for 5.12x5.12 mm2)2-D results

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Optical stylus

Use laser beams for surface measurementComputer-assisted structural analysisResults: 3-D profile of the surfaceFaster scanning speed ( 5 min for 5 12x5 12 Faster scanning speed ( 5 min for 5.12x5.12 mm2)

Optical stylus

Mechanical VS Optical Stylus Optical ProfilometryVisioscan SV 600

Image analysis

Skin surface contourDigital camera take image of replica

Binary image

Linearized image

Extract characteristics of skin furrows

Calculate for change in skin furrows

Image analysis

(a) Camera image of skin relief (b) Binary image

(c) Thinned image (d) Linearized image Pattern analysis

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Change in Skin surface pattern at cheek site with aging

Average of skin roughness

Anisotrophy of skin furrows

Image analysis

Wrinkle measurement (shadowing method)Replica illuminated by oblique light

Analyze peak height and area of shadows from oblique light Analyze peak height and area of shadows from oblique light

Define characters of wrinkles

LimitationHide a small shadowTilt replica ↓peak height

In vivo direct measurement of the skinQuite promisingAdvantage:

Avoid skin hydration effect induced by li i i t i l d

Skin texture measurement

replica impression materials and morphological changes in skin surface induced by hydrationScaliness measurement

Limitation: high variation due to Pulsation of minor skin arteriesBody movementTremble of subjects

In vivo direct skin surface measurement

FOITSTM: based on a touch-free fringe projectionPRIMOSTM: based on active triangulation in conjunction with phase-shift techniqueshift technique

Indentify+readjust previously recorded skin area at VDO rate, measure surface configuration in 3-D

Skin Texture Measurement

Comparison of methodologies

Method Instruments Advantages Disadvantages

Image analysis of replica

Combination of light source and digital camera

Low cost of instrumentSimple manipulationSpatially analyze

Artifact when making replicaNot obtain exact peak height

orientation of skin texture

Lose lower peaks behind higer peak

Optcal profilometry Optical focus profilometerConfocal scanning laser microscopeTriangulation optical profilometer

High accuracyFast analysisReproducible

Artifact when making replica

In vivo measurement

FOITSPRIMOS

Not necessary to take replicaFast analysisRepeated measurement at the same area

Affected by body movement

Skin visiometer SV600 (Courage+Khazaka electronic, Germany)

UV-A light video camera with high resolution to study skin surface directly

Ring shape UVA light source

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Skin visiometer SV600 (Courage+Khazaka electronic, Germany)

Camera connected to computerSpecial sofware calculate a variety of surface skin parameters

Skin smoothness (Se sm)Skin roughness (Se r)Skin roughness (Se r)Scaliness (Se sc)Wrinkles (Se w)

Application to Clinical Research

Application in Clinical ResearchTreatment of acne scars with ablative laser resurfacing

Wk 0

Wk 4

Wk 8

Application in Clinical ResearchStriae treatment with a radiofrequency device

Wk 0

Wk 2

Wk 6

Application in Clinical ResearchEfficacy and Safety of Topical Argireline in the Treatment of Periorbital Wrinkles

Left eye

Right eye

Wk 0 Wk 12

Results obtained from Visioscan and Corneometer showed significant improvement in smoothness and hydration, respectively

Facial mapping

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Application in Clinical Research

Hair study

Target area hair count

Pitfalls

Accurate site mappingStandard environmental controlConfounding factors

Systemic and topical medicationTopical emoillient /cosmeceuticalBathing

References

Serup J, Gemec GBE, Grove GL, eds.Handbook of non-invasive methods and the skin, second edition (2006), New York, CRC press. Wilhelm KP, Berardesca E, Elsner P, Maibach Wilhelm KP, Berardesca E, Elsner P, Maibach HI, eds. Bioengineering of the skin: skin imaging and analysis, second edition (2007), New York, Informa healthcare

Elsner P, Berardesca E, Wilhelm KP, Maibach HI, eds. Bioengineering of the skin: skin biomechanics 2002, New York, CRC press.