Autofluorescence Imaging of the Skin Is an Objective Non-Invasive Technique for Diagnosing Pseudoxanthoma Elasticum

Farkas, Klára; Bozsányi, Szabolcs; Plázár, Dóra; Bánvölgyi, András; Fésűs, Luca; Anker, Pálma; Zakariás, Sára; Lihacova, Ilze; Lihachev, Alexey; Lange, Marta; Arányi, Tamàs; Wikonkál, Norbert; Medvecz, Márta; Kiss, Norbert

doi:10.3390/diagnostics11020260

Cited by 8 publications

(7 citation statements)

References 47 publications

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“…An LED-based MSI device was recently successfully introduced for the detection of recurring skin cancers [43,44] and proved to be applicable in the differentiation of different tumor types from benign lesions based on their mean intensity of autofluorescence (AF) [45]. In addition, MSI has been also utilized for the detection of rare skin disorders [46,47].…”

Section: Figurementioning

confidence: 99%

Quantitative Multispectral Imaging Differentiates Melanoma from Seborrheic Keratosis

et al. 2021

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Melanoma is a melanocytic tumor that is responsible for the most skin cancer-related deaths. By contrast, seborrheic keratosis (SK) is a very common benign lesion with a clinical picture that may resemble melanoma. We used a multispectral imaging device to distinguish these two entities, with the use of autofluorescence imaging with 405 nm and diffuse reflectance imaging with 525 and 660 narrow-band LED illumination. We analyzed intensity descriptors of the acquired images. These included ratios of intensity values of different channels, standard deviation and minimum/maximum values of intensity of the lesions. The pattern of the lesions was also assessed with the use of particle analysis. We found significantly higher intensity values in SKs compared with melanoma, especially with the use of the autofluorescence channel. Moreover, we found a significantly higher number of particles with high fluorescence in SKs. We created a parameter, the SK index, using these values to differentiate melanoma from SK with a sensitivity of 91.9% and specificity of 57.0%. In conclusion, this imaging technique is potentially applicable to distinguish melanoma from SK based on the analysis of various quantitative parameters. For this application, multispectral imaging could be used as a screening tool by general physicians and non-experts in the everyday practice.

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Section: Figurementioning

confidence: 99%

Quantitative Multispectral Imaging Differentiates Melanoma from Seborrheic Keratosis

et al. 2021

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“…Our research group has previously shown this technique to differentiate seborrheic keratosis from melanoma [ 33 ]. In addition, we introduced MSI for the diagnostics of rare skin disorders, including pseudoxanthoma elasticum [ 34 ] and keratinopathic ichthyosis [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

Multispectral Imaging Algorithm Predicts Breslow Thickness of Melanoma

Bozsányi

Varga

Farkas

et al. 2021

JCM

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Breslow thickness is a major prognostic factor for melanoma. It is based on histopathological evaluation, and thus it is not available to aid clinical decision making at the time of the initial melanoma diagnosis. In this work, we assessed the efficacy of multispectral imaging (MSI) to predict Breslow thickness and developed a classification algorithm to determine optimal safety margins of the melanoma excision. First, we excluded nevi from the analysis with a novel quantitative parameter. Parameter s’ could differentiate nevi from melanomas with a sensitivity of 89.60% and specificity of 88.11%. Following this step, we have categorized melanomas into three different subgroups based on Breslow thickness (≤1 mm, 1–2 mm and >2 mm) with a sensitivity of 78.00% and specificity of 89.00% and a substantial agreement (κ = 0.67; 95% CI, 0.58–0.76). We compared our results to the performance of dermatologists and dermatology residents who assessed dermoscopic and clinical images of these melanomas, and reached a sensitivity of 60.38% and specificity of 80.86% with a moderate agreement (κ = 0.41; 95% CI, 0.39–0.43). Based on our findings, this novel method may help predict the appropriate safety margins for curative melanoma excision.

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“…As for the Phenodex skin scores, the absence of significant associations with T50 in the current study might be attributed to the fact that the severity of cutaneous alterations in PXE is only partially reflected by the Phenodex S score as, for example, redundant skin folds due to loss of elasticity might not always reflect higher disease activity compared to extensive papules or plaques. Future studies should, therefore, focus on novel evaluation and grading methods of skin lesion severity, for example, by implementing in vivo autofluorescence and dermoscopy techniques [42,43]. Potential associations between Phenodex cardiac and gastrointestinal scores and T50 could not be adequately evaluated in our current PXE patient population due to the low prevalence of Phenodex-scored events such as myocardial infarction or stomach bleeding.…”

Section: Discussionmentioning

confidence: 99%

Serum Calcification Propensity T50 Associates with Disease Severity in Patients with Pseudoxanthoma Elasticum

Nollet

Gils

Fischer

et al. 2022

JCM

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Pseudoxanthoma elasticum (PXE) is a currently intractable genetic disorder characterized by progressive ectopic calcification in the skin, eyes and arteries. Therapeutic trials in PXE are severely hampered by the lack of reliable biomarkers. Serum calcification propensity T50 is a blood test measuring the functional anticalcifying buffer capacity of serum. Here, we evaluated T50 in PXE patients aiming to investigate its determinants and suitability as a potential biomarker for disease severity. Fifty-seven PXE patients were included in this cross-sectional study, and demographic, clinical, imaging and biochemical data were collected from medical health records. PXE severity was assessed using Phenodex scores. T50 was measured using a validated, nephelometry-based assay. Multivariate models were then created to investigate T50 determinants and associations with disease severity. In short, the mean age of patients was 45.2 years, 68.4% was female and mean serum T50 was 347 min. Multivariate regression analysis identified serum fetuin-A (p < 0.001), phosphorus (p = 0.007) and magnesium levels (p = 0.034) as significant determinants of T50, while no correlations were identified with serum calcium, eGFR, plasma PPi levels or the ABCC6 genotype. After correction for covariates, T50 was found to be an independent determinant of ocular (p = 0.013), vascular (p = 0.013) and overall disease severity (p = 0.016) in PXE. To conclude, shorter serum T50—indicative of a higher calcification propensity—was associated with a more severe phenotype in PXE patients. This study indicates, for the first time, that serum T50 might be a clinically relevant biomarker in PXE and may thus be of importance to future therapeutic trials.

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Autofluorescence Imaging of the Skin Is an Objective Non-Invasive Technique for Diagnosing Pseudoxanthoma Elasticum

Cited by 8 publications

References 47 publications

Quantitative Multispectral Imaging Differentiates Melanoma from Seborrheic Keratosis

Quantitative Multispectral Imaging Differentiates Melanoma from Seborrheic Keratosis

Multispectral Imaging Algorithm Predicts Breslow Thickness of Melanoma

Serum Calcification Propensity T50 Associates with Disease Severity in Patients with Pseudoxanthoma Elasticum

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