Image analysis systems to calculate the surface area of vitiligo lesions: A systematic review of measurement properties

Geel, Nanja van; Saeys, Imke; Causenbroeck, Jérôme Van; Duponselle, Jolien; Grine, Lynda; Pauwels, N.; Hilhorst, Niels; Herbelet, Sandrine; Ezzedine, Khaled; Speeckaert, Reinhart

doi:10.1111/pcmr.13056

Cited by 4 publications

(1 citation statement)

References 46 publications

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“…In clinical practice, relying only on visual observation of vitiligo lesions to judge the stage of the disease and guide treatment easily results in misjudgment, which also affects the efficacy of treatment. Previous studies have mostly used visual observation and patient recall for the diagnosis of vitiligo, 16,17 which frequently causes misjudgment of lesions with atypical and inconspicuous clinical features. The treatment of vitiligo is based on the presence of Koebner's phenomenon, 18 hypopigmentation, trichromatosis, 19 and confetti‐like depigmentation, as these features have long been thought to be associated with disease activity in vitiligo 20 .…”

Section: Discussionmentioning

confidence: 99%

In‐depth study of Wood's lamp examination combined with reflective confocal laser scanning microscopy for the guidance of vitiligo staging and treatment

Hou,

Wei,

Jiang

et al. 2023

J of Cosmetic Dermatology

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BackgroundBoth Wood's lamp and reflective confidential laser scanning microcopy are helpful for the diagnosis and treatment of vitiligo. However, there is few research that contains large samples and consistent observations.AimsTo analyze the characteristics of Wood's lamp images and reflectance confocal microscopy (RCM) images of vitiligo lesions and to evaluate their significance in vitiligo staging.MethodsWe analyzed the characteristics of RCM images, Wood's lamp images, the vitiligo disease activity (VIDA) score, and clinical features to guide vitiligo staging and treatment.ResultsThe expert consensus based on the clinical features, VIDA score, Wood's lamp findings, and isomorphic response was consistent with the Wood's lamp findings (χ2 = 3.63, p > 0.05) and RCM findings (χ2 = 3.60, p > 0.05) in diagnosing vitiligo and assessing the disease stage. There was a correlation between the three lesion grades based on the Wood's lamp findings and the stage of vitiligo (p < 0.01). Lesions that appeared porcelain white under the Wood's lamp were in the slowly progressive stage; lesions that appeared gray‐white or trichromatic under the Wood's lamp were in the rapidly progressive stage; lesions with clear borders under the Wood's lamp needed further analysis by RCM for the stage to be determined; lesions with blurred borders under the Wood's lamp were in the rapidly progressive stage; lesions that were visible under the naked eye and under the Wood's lamp were in the rapidly progressive stage.ConclusionThe study demonstrates a reliable correlation between the findings of RCM (a sophisticated expensive tool) and Wood's lamp examination (a simple, readily available, inexpensive tool) in the assessment of the disease activity of vitiligo lesions.

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Section: Discussionmentioning

confidence: 99%

In‐depth study of Wood's lamp examination combined with reflective confocal laser scanning microscopy for the guidance of vitiligo staging and treatment

Hou,

Wei,

Jiang

et al. 2023

J of Cosmetic Dermatology

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Evaluation of Facial Vitiligo Severity with a Mixed Clinical and Artificial Intelligence Approach

Hillmer,

Merhi,

Boniface

et al. 2024

Journal of Investigative Dermatology

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Reliability and agreement testing of a new automated measurement method to determine facial vitiligo extent using standardized ultraviolet images and a dedicated algorithm

Marin Dit Bertoud,

Bertold,

Ezzedine

et al. 2023

British Journal of Dermatology

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Background Facial repigmentation is the primary outcome measure for most vitiligo trials. The Facial Vitiligo Area Scoring Index (F-VASI) score is often chosen as the primary outcome measure to assess the efficacy of treatments for facial vitiligo. Although useful, this scoring system remains subjective and has several limitations. Objectives To assess agreement and reliability of an algorithmic method to measure percent depigmentation of vitiligo on the face. Methods We developed a dedicated algorithm called Vitil-IA® to assess depigmentation on standardized facial UV pictures. Then, we conducted a cross-sectional study using the framework of the ERASE trial in 22 consecutive patients attending a tertiary care center for vitiligo. Depigmentation was analyzed before any treatment, and for 7 of them after 3 and 6 months of narrowband ultraviolet B treatment combined with 16 mg of methylprednisolone, both used twice weekly. Inter-operator and inter-acquisition repeatabilities were assessed for the algorithm. The results of the algorithmic measurement were then compared to the F-VASI and percentage of depigmented skin scores assessed by 13 raters, including 7 experts in the grading of vitiligo lesions. Results A total of 31 sets of pictures were analyzed with the algorithmic method. Internal validation showed excellent reproducibility, with a variation <3%. The percentage of depigmentation assessed by the system showed high agreement with the percent depigmentation assessed by raters (Mean Error (ME)=-11.94 and Mean Absolute Error (MAE) = 12.71 for non-expert group and ME = 0.43 and MAE = 5.57 for expert group). The intraclass correlation coefficient (ICC) for F-VASI was 0.45(95% CI 0.29–0.62) and 0.52(95% CI 0.37–0.68) for non-experts and experts, respectively. When results were analyzed separately for homogeneous and heterogeneous depigmentation, the ICC for homogeneous depigmentation was 0.47(95% CI 0.31–0.77) and 0.85(95% CI 0.72–0.94) for non-experts and experts, respectively. When grading heterogeneous depigmentation, the ICC was 0.19(95% CI 0.05–0.43) and 0.38(95% CI 0.20–0.62) for non-experts and experts, respectively. Conclusions This study demonstrates that the Vitil-IA algorithm provides reliable assessment of facial involvement in vitiligo. It also underlines the limitations of the F-VASI score when performed by non-experts for homogeneous vitiligo depigmentation, and in all raters when depigmentation is heterogeneous.

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Image analysis systems to calculate the surface area of vitiligo lesions: A systematic review of measurement properties

Cited by 4 publications

References 46 publications

In‐depth study of Wood's lamp examination combined with reflective confocal laser scanning microscopy for the guidance of vitiligo staging and treatment

In‐depth study of Wood's lamp examination combined with reflective confocal laser scanning microscopy for the guidance of vitiligo staging and treatment

Evaluation of Facial Vitiligo Severity with a Mixed Clinical and Artificial Intelligence Approach

Reliability and agreement testing of a new automated measurement method to determine facial vitiligo extent using standardized ultraviolet images and a dedicated algorithm

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