Department of Dermatology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 701, Taiwan, ROC.
International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan, 701, Taiwan, ROC.
Sci Rep. 2022 May 6;12(1):7469. doi: 10.1038/s41598-022-11573-2.
In clinical settings, although Psoriasis Area and Severity Index (PASI) scoring system can provide a quick visual assessment of the severity of psoriasis vulgaris, there is still a strong demand for higher efficiency and accuracy in quantifying the inflammation status of psoriatic lesions. Currently, there are already commercial systems, such as the Courage + Khazaka Corneometer and Mexameter that measure skin capacitance and optical reflectance, for conveniently quantifying the status of skin barrier function and erythema of skin. Despite numerous comparisons of the Courage + Khazaka system with the PASI scoring system, they are rarely compared on parity with diffuse reflectance spectroscopy (DRS) based systems. In this study, we employed a custom-built DRS system shown to be able to determine the skin water-protein binding status and the hemoglobin concentration, and we performed cross-validation of the DRS measurement results with the readings derived from the Corneometer and Mexameter as well as a portion of the PASI scores. Our results revealed that the erythema readings from the Mexameter were a good representation of skin oxygenated hemoglobin but not the deoxygenated hemoglobin. On the other hand, the dermatologists recruited in this study were inclined to rate higher scores on the "erythema" category as skin's deoxygenated hemoglobin level was higher. Thus, the Mexameter derived erythema readings may not be coherent with the PASI erythema scores. Further, the Corneometer derived skin capacitance readings were well correlated to the PASI "desquamation" and "thickness" scores, while the PASI "desquamation" evaluation was a dominating factor contributing to the DRS deduced water-protein binding status. We conclude that the DRS method could be a valuable addition to existing skin capacitance/reflectance measurement systems and the PASI scoring system toward achieving a more efficient and objective clinical psoriasis vulgaris severity evaluation.
在临床环境中，虽然银屑病面积和严重程度指数（PASI）评分系统可以快速直观地评估寻常型银屑病的严重程度，但人们仍然强烈需要更高的效率和准确性来量化银屑病皮损的炎症状态。目前，已经有商业系统，如 Courage + Khazaka 皮脂计和 Mexameter，用于方便地量化皮肤屏障功能和皮肤红斑的状态，这些系统分别通过测量皮肤电容和光反射来实现。尽管已经对 Courage + Khazaka 系统与 PASI 评分系统进行了大量比较，但很少将它们与基于漫反射光谱（DRS）的系统进行平等比较。在这项研究中，我们使用了一种经过验证的定制 DRS 系统，可以确定皮肤水蛋白结合状态和血红蛋白浓度，并对 DRS 测量结果与 Corneometer 和 Mexameter 的读数以及部分 PASI 评分进行了交叉验证。我们的研究结果表明，Mexameter 的红斑读数很好地代表了皮肤的氧合血红蛋白，但不能代表去氧血红蛋白。另一方面，参与这项研究的皮肤科医生倾向于对“红斑”类别给予更高的评分，因为皮肤的去氧血红蛋白水平较高。因此，Mexameter 得出的红斑读数可能与 PASI 红斑评分不一致。此外，Corneometer 得出的皮肤电容读数与 PASI“脱屑”和“厚度”评分高度相关，而 PASI“脱屑”评估是导致 DRS 推断的水蛋白结合状态的主要因素。我们的结论是，DRS 方法可以作为现有皮肤电容/反射测量系统和 PASI 评分系统的有益补充，有助于实现更高效和客观的寻常型银屑病严重程度评估。
