Skin Biometrology:What’s New?

Alireza Firooz, MD

Professor of Dermatology

Center for Research & Training in Skin Diseases & Leprosy

Tehran University of Medical Sciences

• Center for Research & Training in Skin Diseases & Leprosy (CRTSDL) is one of research centers of Tehran University of Medical Sciences (TUMS)

• CRTSDL is the oldest and biggest national skin research center in Iran and is established in 1992.

Research & Education Units

• Tropical diseases:– leishmaniasis – leprosy

• Skin Biometrology• Dermatitis• Dermatoepidemiology

Bioengineering in Dermatology

• Study of Skin Function• Create new diagnostic devices

Applications for Skin Testing Devices

• To assess the state of the skin, the human eye is a perfect instrument• However, it has certain limitations:• no storing of images for comparison of the course of the

skin treatment• The human eye can only look at the skin surface, not at

deeper skin layers• only subjective information• two different persons may judge the skin condition

differently

Techniques

• Measurement of epidermal hydration• Measurement of TEWL• Measurement of skin surface pH• Measurement of skin surface lipid• Measurement of skin erythema• Measurement of skin pigmentation• Measurement of skin elasticity• Measurement of skin wrinkles• Stratum corneum cohesion• Skin frictional properties

Techniques• Skin digital imaging• Skin surface microscopy (Dermatoscopy)• Confocal laser microscopy• Ultrasonography• MRI• Optical coherent tomography• Capillary microscopy• Laser Doppler

Characteristics of techniques

• Non-invasive: allow multiple measurements• Objective: obtain quantitative values for statistical

analysis• Sensitive: reveal skin disturbances before clinical

manifestation• In vivo: information in real time without violating

spontaneous disease course• Reproducible: same information all over the world

Applications

• Investigation of physiologic parameters of normal skin

• Examination of skin changes after various exogenous influences

• Diagnosis and monitoring of skin diseases• Evaluation of response to therapeutic

interventions• Safety and efficacy evaluation of topical

preparations

• The EEMCO group (European Expert Group on Efficacy Measurement of Cosmetics and Other Products) was formed in 1994.

• It has developed several guidelines with the purpose to standardize the measurement procedures and documentations.

• The International Society of Biophysics and Imaging of the Skin is founded in 2005 (Chair: Prof Philippe Humbert, France).

• The Journal of Skin Research & Technology established in 1995 (Editor: Prof. Jergen Serup, Denmark)

• Measuring the Skin (1st ed). Agache P, Humbert P . Springer 2004.

• Measuring the Skin (2nd ed). Maibach H, Humbert P. Springer 2013.

DermaLab

• The Pharmaceutical, Cosmeceutical, & Hygienic Products Clinical Evaluation Unit (DermaLab) is established in February 2010 to provide service to– industry, – research centres, – clinicians, – patients.

• This service includes consultation, research project development, in vivo efficacy and safety tests, and training courses in the fields of cosmetics and cutaneous biometrology.

DermaLab

A Reference centre

• The only reference centre in the country for standardisation of pharmaceutical, cosmeceutical and hygienic products in terms of their effects on skin biophysical parameters.

• The only centre in the country which has been given the authority by the Ministry of Health to issue certificates of safety and effectiveness for pharmaceutical, cosmeceutical and hygienic products

Patients

• Ten patients with postoperative linear abdominal scars greater than 6 cm in length were enrolled in this prospective study.

• The scar was divided into three equal parts, two parts were randomly assigned to be treated and one part was assigned to no treatment as the control.

• One treated part was treated with the PDL on the day of suture removal and the other was treated 9 weeks after suture removal.

Assessment of efficacy of platelet-rich plasma (PRP) on infraorbital dark circles and crow’s

feet wrinkles.Journal of Cosmetic Dermatology. In press

(2013)

Firooz A, Mehryan P, Zartab H, Rajabi A

Comparison of the echogenicity of pigmented basal cell carcinoma with pigmented

melanocytic nevus of head and neck using high frequency ultrasound imaging

Alireza Firooz, MD, Parisa Khoshpouri, MD; Pegah Khoshpouri, MD; Mohammad Pooya, MD, PhD; Hamed Zartab, MD; Ali Rajabi, MD;

Kambiz Kamyab, MD

Center for Research & Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran

Poster ID: IST13-0635

MethodsThirty BMNs and 33 BCCs in the head and neck area were evaluated by using HFUS with 22- and 50-MHz hand-held transducers. The diagnosis of all lesions were later confirmed histopathologically. The echo-density was measured in the middle of the lesions as well as in the mid-dermis of the immediate surrounding normal skin.

BMN lesion scan with 22-MHz probe BMN lesion scan with 50-MHz probe

ResultsDiagnosis N Mean Std. Deviation P-Value

BCCNLSkin Density22 33 29.55 14.425

0.849NLSkin Density50 33 29.88 14.285

BMNNLSkin Density22 30 25.80 11.746

0.200NLSkin Density50 30 28.27 13.057

BCCLesion Density22 33 15.73 7.739

0.611Lesion Density50 33 15.15 10.666

BMNLesion Density22 30 12.67 6.845

0.817Lesion Density50 30 12.87 6.606

Comparison of echo-densities of BCC and BMN with normal surrounding skin (22- & 50-MHz probe):

Diagnosis N Mean Std. Deviation P-Value

Dif. NL-Lesion 22BCC 33 13.8182 9.14622

0.755BMN 30 13.1333 8.11866

Ratio. Nl/Lesion 22BCC 33 1.9890 0.60764

0.087BMN 30 2.3103 0.84718

Comparison of echo-density ratio of BCC/normal skin vs. BMN/normal skin:

Conclusion

1. There was not any significant difference between echodensity of BCC & BMN, so HFUS can not differentiate them.

2. Both BCC and BMN are significantly less echogenic than normal surrounding skin, so HFUS is a good non-invasive method for localization of these lesions, which can be used prior to surgery.

3. It has been shown than HFUS can help to differentiate between blue nevi & metastases of melanoma [7].

4. Also HFUS can help to determine length and width of BCC & SCC [6], and BCC [1, 9] prior to surgery and thus reduce number of surgical stages.

5. However, histology is still the gold standard for diagnosis of these lesions.

Thank you for your attention!