Bielfeldt Stephan, Buttgereit Peter, Brandt Marianne, Springmann Gunja, Wilhelm Klaus-Peter
proDERM Institute for Applied Dermatological Research GmbH, Schenefeld, Germany.
Skin Res Technol. 2008 Aug;14(3):336-46. doi: 10.1111/j.1600-0846.2008.00300.x.
The majority of women suffer from the unattractive sight of dimpling skin on the thighs and buttocks, globally known as cellulite. Cellulite can be regarded as the most investigated non-disease, because, from the cosmetic viewpoint, most women desire a reduction in cellulite severity. Despite investigations made, cellulite is still not well understood at the cellular level, which leads to controversy regarding the investigative methods for cellulite reduction as well as the development of products to treat cellulite skin.
The aim of our work was to improve the set up of macrophotography for making images of dimpled skin and to automatize image analysis of 20 MHz ultrasound imaging - these two methods being just two of a variety of available methods for investigating cellulite skin.
Macrophotography was standardized on the aspects of volunteer's positioning, skin illumination, background used, and camera position. It was performed before, during and after a 3-month-treatment of a cosmetic product. Scoring assessments of the generated images were made by the volunteers themselves as well as by six trained experts. Ultrasound imaging was performed at the baseline visit in order to correlate the newly developed analysis with the visually rated cellulite score. A second study is also presented showing a variety of parameters that can be used for cosmetic testing of cellulite products: skin firmness, blood circulation and circumferential thigh measurements.
Standardization of macrophotography minimized differences in image features between assessment times, therefore, enabling follow-up rating assessments of the images. A custom-made rating program simplified the scoring procedure by presenting images as blind and randomized, and by implementing computer-based analysis using an online rating scale. Volunteers and experts scored significant improvement of skin appearance over the course of a 3-month cosmetic treatment. Image analysis of ultrasound imaging was automatized, and a modification of the commonly known roughness parameter Ra was implemented to characterize cellulite severity. Comparison with the visually rated cellulite score showed an existing correlation between the score and the modified parameter Ra(m). Further parameters investigated in an exemplary study, as mentioned above, demonstrated a significant improvement of skin appearance after treatment with a cosmetic product.
Macrophotography and ultrasound imaging can be regarded as important tools for determining and quantifying the aspects of cellulite. With a gold standard missing for investigating cellulite severity, these two methods may not determine cellulite at the cellular level, but they do characterize the skin appearance so typical for cellulite. Combined with a variety of other methods, macrophotography and ultrasound imaging can very well define cellulite-reducing efficacy from the cosmetic point of view.
全球大多数女性都饱受大腿和臀部皮肤出现橘皮组织（俗称蜂窝组织炎）的困扰。橘皮组织可被视为研究最多的非疾病状况，因为从美容角度来看，大多数女性都希望减轻橘皮组织的严重程度。尽管已经进行了诸多研究，但在细胞层面上，橘皮组织仍未被充分了解，这导致在减少橘皮组织的研究方法以及治疗橘皮组织皮肤的产品开发方面存在争议。
我们工作的目的是改进用于拍摄橘皮样皮肤图像的微距摄影设置，并实现20兆赫超声成像的图像分析自动化——这两种方法只是众多用于研究橘皮组织皮肤的可用方法中的两种。
微距摄影在志愿者的体位、皮肤照明、背景使用和相机位置等方面进行了标准化。在使用一种美容产品进行为期3个月的治疗之前、期间和之后都进行了拍摄。生成图像的评分评估由志愿者自己以及六位经过培训的专家进行。在基线访视时进行了超声成像，以便将新开发的分析与视觉评定的橘皮组织评分相关联。还展示了另一项研究，该研究显示了可用于橘皮组织产品美容测试的各种参数：皮肤紧致度、血液循环和大腿围度测量。
微距摄影的标准化最大限度地减少了评估时间之间图像特征的差异，因此能够对图像进行后续评分评估。一个定制的评分程序通过以盲法和随机方式呈现图像，并使用在线评分量表进行基于计算机的分析，简化了评分过程。志愿者和专家对为期3个月的美容治疗过程中皮肤外观的改善进行了显著评分。超声成像的图像分析实现了自动化，并对常用的粗糙度参数Ra进行了修改，以表征橘皮组织的严重程度。与视觉评定的橘皮组织评分进行比较，结果显示该评分与修改后的参数Ra(m)之间存在相关性。如上述示例研究中所调查的其他参数表明，使用美容产品治疗后皮肤外观有显著改善。
微距摄影和超声成像可被视为确定和量化橘皮组织各方面情况的重要工具。由于缺乏用于研究橘皮组织严重程度的金标准，这两种方法可能无法在细胞层面上确定橘皮组织，但它们确实能够表征典型的橘皮组织皮肤外观。与其他多种方法相结合，微距摄影和超声成像能够从美容角度很好地界定减少橘皮组织的功效。
