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Validation of a protocol for the assessment of skin temperature and blood flow in childhood localised scleroderma


Howell, K J; Lavorato, A; Visentin, M T; Smith, R E; Schaefer, G; Jones, C D; Weibel, L; Denton, C P; Harper, J I; Woo, P (2009). Validation of a protocol for the assessment of skin temperature and blood flow in childhood localised scleroderma. Skin Research and Technology, 15(3):346-356.

Abstract

BACKGROUND/PURPOSE: Localised scleroderma (LS) is the most common form of scleroderma seen in children, and usually presents unilaterally. Infrared thermography (IRT) and laser Doppler (LD) have both been reported to be useful in assessing the active, inflammatory stage of LS. We developed and validated a protocol using these techniques for the assessment of unilateral LS activity in children. METHOD: We investigated the spatial variability and repeatability of LD measurements from adult control forearm skin, and the inter- and intra-operator reproducibility of both LD blood flow trace analysis and IRT skin temperature analysis. Software was developed to produce overlay images of thermograms onto digital photographs of skin sites. In a group of seven adult control subjects, we established the normal range for skin temperature and LD blood flow at six standardised sites (forehead, cheek, abdomen, back, arm and leg), and measured contralateral differences in readings. In a group of 34 children with LS, we investigated the skin temperature and LD blood flow in unaffected skin at the same six sites. RESULTS: In adults, physiological variability in LD blood flow and skin temperature between the two sides of the body was found to be greater than the uncertainty introduced into the measurements by (inter alia) limited intra- or inter-operator reproducibility. The cheek displayed the highest mean asymmetry in both skin temperature (0.5 degrees C) and LD blood flow (40%). CONCLUSION: Our protocol combines IRT, LD and photography for LS assessment in children, and establishes a normal range of readings in line with other authors.

BACKGROUND/PURPOSE: Localised scleroderma (LS) is the most common form of scleroderma seen in children, and usually presents unilaterally. Infrared thermography (IRT) and laser Doppler (LD) have both been reported to be useful in assessing the active, inflammatory stage of LS. We developed and validated a protocol using these techniques for the assessment of unilateral LS activity in children. METHOD: We investigated the spatial variability and repeatability of LD measurements from adult control forearm skin, and the inter- and intra-operator reproducibility of both LD blood flow trace analysis and IRT skin temperature analysis. Software was developed to produce overlay images of thermograms onto digital photographs of skin sites. In a group of seven adult control subjects, we established the normal range for skin temperature and LD blood flow at six standardised sites (forehead, cheek, abdomen, back, arm and leg), and measured contralateral differences in readings. In a group of 34 children with LS, we investigated the skin temperature and LD blood flow in unaffected skin at the same six sites. RESULTS: In adults, physiological variability in LD blood flow and skin temperature between the two sides of the body was found to be greater than the uncertainty introduced into the measurements by (inter alia) limited intra- or inter-operator reproducibility. The cheek displayed the highest mean asymmetry in both skin temperature (0.5 degrees C) and LD blood flow (40%). CONCLUSION: Our protocol combines IRT, LD and photography for LS assessment in children, and establishes a normal range of readings in line with other authors.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:17 Feb 2010 12:46
Last Modified:05 Apr 2016 13:57
Publisher:Wiley-Blackwell
ISSN:0909-752X
Publisher DOI:10.1111/j.1600-0846.2009.00371.x
PubMed ID:19624432
Permanent URL: http://doi.org/10.5167/uzh-31137

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