Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, 19 Raiņa Bulvaris, Rīga, LV-1586, Latvia.
Department of Clinical Sciences, College of Veterinary Medicine, NC State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
Vet Dermatol. 2021 Apr;32(2):183-e46. doi: 10.1111/vde.12932. Epub 2021 Jan 6.
To estimate the extent and severity of atopic dermatitis (AD)-related skin lesions, clinical trials enrolling dogs with AD often use categorical scales such as the Canine Atopic Dermatitis Extent and Severity Index, 4 iteration (CADESI-04) and Canine Atopic Dermatitis Lesion Index (CADLI). Despite recent progress in the standardization of these AD-grading scales, the evaluation of the severity of skin lesions (including erythema) remains subjective.
To validate an optical set-up with a smartphone and a dermatoscope for the objective estimation of skin erythema severity in atopic dogs.
Forty-three dogs with AD.
An erythema index (EI) was calculated from calibrated skin images and compared to the dermatologist's erythema severity estimate using the erythema grading scale used in the CADESI-04, as well as an ad hoc Visual Analog Scale (VAS) with a continuous palette of red shades.
We found a strong correlation based on the Spearman rank correlation coefficient between all erythema valuations: CADESI-04 and VAS: 0.93 [95% CI: (0.85, 0.96)]; CADESI-04 and EI: 0.85 (0.72, 0.92); VAS and EI: 0.82 (0.67, 0.91). There was a good agreement between the objective EI and CADESI-04-based estimates because 71% of samples were classified in the same erythema severity category. When comparing the EI and the VAS, the standard deviation of misestimates was 12% (maximum 100%).
The proposed optical set-up has the potential to make erythema severity estimation objective, thus leading to more reliable AD severity scales for the use in experimental canine AD models or in clinical trials enrolling atopic dogs.
为了评估特应性皮炎（AD）相关皮肤损伤的程度和严重程度，招募 AD 犬的临床试验通常使用类别量表，如犬特应性皮炎严重程度指数 4 迭代（CADESI-04）和犬特应性皮炎病变指数（CADLI）。尽管这些 AD 分级量表的标准化最近取得了进展，但皮肤病变（包括红斑）严重程度的评估仍然是主观的。
验证一种带有智能手机和皮肤镜的光学设备，用于客观评估特应性犬的皮肤红斑严重程度。
43 只 AD 犬。
从校准后的皮肤图像中计算红斑指数（EI），并使用 CADESI-04 中使用的红斑严重程度量表以及带有连续红色色调的专用视觉模拟量表（VAS）与皮肤科医生的红斑严重程度估计值进行比较。
我们发现基于 Spearman 秩相关系数的所有红斑评估值之间存在很强的相关性：CADESI-04 和 VAS：0.93 [95%CI：（0.85, 0.96）]；CADESI-04 和 EI：0.85（0.72, 0.92）；VAS 和 EI：0.82（0.67, 0.91）。客观 EI 和基于 CADESI-04 的估计之间存在良好的一致性，因为 71%的样本被分类为相同的红斑严重程度类别。当比较 EI 和 VAS 时，估计错误的标准差为 12%（最大 100%）。
所提出的光学设备有可能使红斑严重程度评估客观化，从而为实验性犬 AD 模型或招募特应性犬的临床试验中使用更可靠的 AD 严重程度量表提供了可能性。
