Characterization and pattern recognition of color images of dermatological ulcers: a pilot study

We present color image processing methods for the char\-ac\-te\-ri\-za\-tion of images of dermatological lesions for the purpose of content-based image retrieval (CBIR) and computer-aided di\-ag\-no\-sis. The intended application is to segment the images and perform classification and analysis of the tissue composition of skin lesions or ulcers, in terms of granulation (red), fibrin (yel\-low), necrotic (black), callous (white), and mixed tissue composition. The images were analyzed and classified by an expert dermatologist following the red-yellow-black-white model. Automatic segmentation was performed by means of clustering using Gauss\-ian mixture modeling, and its performance was evaluated by deriving the Jaccard coefficient between the automatically and manually segmented images. Statistical texture features were derived from cooccurrence matrices of RGB, HSI, L$^*$a$^*$b$^*$, and L$^*$u$^*$v$^*$ color components. A retrieval engine was implemented using the k-nearest-neighbor classifier and the Euclidean, Man\-hat\-tan, and Chebyshev distance metrics. Classification was performed by means of a metaclassifier using logistic regression. The average Jaccard coefficient after the segmentation step between the automatically and manually segmented images was 0.560, with a standard deviation of 0.220. The performance in CBIR was mea\-sured in terms of precision of retrieval, with average values of up to 0.617 obtained with the Chebyshev distance. The metaclassifier yielded an average area under the receiver operating char\-ac\-ter\-is\-tic curve of 0.772

CAD Tool for Burn Diagnosis

In this paper a new system for burn diagnosis is proposed. The aim of the system is to separate burn wounds from healthy skin, and the different types of burns (burn depths) from each other, identifying each one. The system is based on the colour and texture information, as these are the characteristics observed by physicians in order to give a diagnosis. We use a perceptually uniform colour space (L*u*v*), since Euclidean distances calculated in this space correspond to perceptually colour differences. After the burn is segmented, some colour and texture descriptors are calculated and they are the inputs to a Fuzzy-ARTMAP neural network. The neural network classifies them into three types of burns: superficial dermal, deep dermal and full thickness. Clinical effectiveness of the method was demonstrated on 62 clinical burn wound images obtained from digital colour photographs, yielding an average classification success rate of 82 % compared to expert classified images

Human Face Mapping Based on TEWL, Hydration and Ultrasound

Biophysical properties of the skin vary depending on the skin location. Such properties include skin structure, density of skin layers, pH, temperature, hydration and Transepidermal Water Loss (TEWL).Modern technologies and quantitative methods allow reading and analysing the skin properties using in-vivo based analysis. One goal of such analysis is partitioning the skin in areas with similar properties, which is referred as mapping. The purpose of our study, also the novelty of the project, is mapping of the facial skin in terms of TEWL, hydration and skin layer thickness, as well as measuring the effect of physical exercise on facial skin; where possible, effect of sex and age were also considered. TEWL was measured with AquaFlux, skin layer thickness was measured with Episcan high resolution ultrasound imaging, and skin hydration was measured with Epsilon. Our study reveals material difference of TEWL between the facial sites being analysed; the largest differences were noted between the lips and the neck. It was found that skin hydration levels decrease with the advancement of age. Skin hydration readings reveal larger general effect of exercise for females, and strongest effect for males observed on the nose. Skin ultrasound images were used in two ways. First, face was mapped in terms of the thickness of the individual skin layers and such mapping was found to be different for each layer. Secondly, the differences between the sites in terms of thickness were quantified using Welch test, where age was also found to be a factor. Several Machine Learning-based classifiers of the skin location were also trained, which are based on the cross-sectional image with moderate positive outcome. The study showed that the combination of TEWL, Epsilon and Episcan provides useful information about skin health. The study also showed variations in the values for different facial skin sites of several skin samples, which was likely due to the degree of corneocyte formation, the lipid contents of the Stratum Corneum (SC), skin temperature, damaged barrier function, bodily health and skin blood flow

A systematic review of objective burn scar measurements

BackgroundProblematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor. At present, there are few treatments available in the clinic to control adverse scarring, but experimental pharmacological anti-scarring strategies are now beginning to emerge. Their comparative success must be based on objective measurements of scarring, yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients. However, several techniques and devices are being introduced that allow objective analysis of the burn scar. The aim of this article is to evaluate various objective measurement tools currently available and recommend a useful panel that is suitable for use in clinical trials of anti-scarring therapies.MethodsA systematic literature search was done using the Web of Science, PubMed and Cochrane databases. The identified devices were then classified and grouped according to the parameters they measured.The tools were then compared and assessed in terms of inter- and intra-rater reproducibility, ease of use and cost.ResultsAfter duplicates were removed, 5062 articles were obtained in the search. After further screening, 157 articles which utilised objective burn scar measurement systems or tools were obtained. The scar measurement devices can be broadly classified into those measuring colour, metric variables, texture, biomechanical properties and pathophysiological disturbances.ConclusionsObjective scar measurement tools allow the accurate and reproducible evaluation of scars, which is important for both clinical and scientific use. However, studies to evaluate their relative performance and merits of these tools are scarce, and there remain factors, such as itch and pain, which cannot be measured objectively. On reviewing the available evidence, a panel of devices for objective scar measurement is recommended consisting of the 3D cameras (Eykona/Lifeviz/Vectra H1) for surface area and volume, DSM II colorimeter for colour, Dermascan high-frequency ultrasound for scar thickness and Cutometer for skin elasticity and pliability

Analysis of the Role of Bacillus oleronius Proteins in the Induction of Rosacea and Evaluation of Novel Therapeutics for the Treatment of Dermal and Ocular Rosacea

Rosacea is a chronic inflammatory condition predominantly affecting the face on the cheeks, forehead, nose, chin and in some cases eyes. The primary diagnostic feature of rosacea is persistent erythema on the central region of the face. Distinct secondary features help to diagnose one of the four subtypes of rosacea and commonly include telangiectasia, flushing, papule and pustules, thickening of the skin and oedema. Rosacea is a debilitating condition that can impact on a patients emotional and psychological state. The aetiology of this dermatological condition is unknown and multiple factors contribute to the onset of rosacea and exacerbate symptoms. Exogenous factors such as radiation or diet, and endogenous factors such as sebum alteration or stress, can change skin homeostasis. These factors can influence resident microbiota, which may alter skin homeostasis and induce the production of virulence factors. The increased density of Demodex mites in rosacea patients has been demonstrated previously. Demodex mites cause micro-abrasions to the skin surface and weaken the skin barrier function. Bacillus oleronius isolated from Demodex is a bacterium associated with rosacea pathogenesis and patient serum previously exposed to antigen have displayed immune reactivity. The work in this thesis investigated the effect of different stress conditions on B. oleronius antigen production. The proteome of B. oleronius was assessed in response to temperature stress and oxidative stress to evaluate differential abundance in protein production. B. oleronius proteins may contribute to the over-activation of the innate immune response, leading to increased gene expression of cytokines, increased tissue damage and onset of chronic inflammation. The treatment and management of rosacea is targeted towards symptomatic relief, predominantly with the aid of antibiotics. Some treatments demonstrate antibacterial and anti-inflammatory effects, both of which help to treat patient symptoms. Three blocking agents were evaluated in this research to determine the potential capturing of B. oleronius antigens. Mucin is naturally present in tear fluid and protects the epithelial barrier. This antimicrobial displayed potential as an adhesive decoy against antigen. A novel saline therapeutic was also investigated to treat rosacea patients and alleviate symptoms. The novel salt based formulation demonstrated effective anti-inflammatory properties in two pilot studies. There is no cure for rosacea, however the work presented here demonstrated potential therapeutics for rosacea patient treatment against B. oleronius antigens

Global Perspective on Diabetic Foot Ulcerations

Over the last decade, it is becoming increasingly clear that diabetes mellitus is a global epidemic. The influence of diabetes is most readily apparent in its manifestation in foot complications across cultures and continents. In this unique collaboration of global specialists, we examine the explosion of foot disease in locations that must quickly grapple with both mobilizing medical expertise and shaping public policy to best prevent and treat these serious complications. In other areas of the world where diabetic foot complications have unfortunately been all too common, diagnostic testing and advanced treatments have been developed in response. The bulk of this book is devoted to examining the newest developments in basic and clinical research on the diabetic foot. It is hoped that as our understanding of the pathophysiologic process expands, the devastating impact of diabetic foot complications can be minimized on a global scale

Correlating the Effect of Dynamic Variability in the Sensor Environment on Sensor Design

This dissertation studies the effect of biofluid dynamics on the electrochemical response of a wearable sensor for monitoring of chronic wounds. The research investigates various dynamic in vivo parameters and correlates them with experimentally measured behavior with wound monitoring as a use case. Wearable electrochemical biosensors suffer from several unaddressed challenges, like stability and sensitivity, that need to be resolved for obtaining accurate data. One of the major challenges in the use of these sensors is continuous variation in biofluid composition. Wound healing is a dynamic process with wound composition changing continuously. This dissertation investigates the effects of several in vivo biochemical and environmental parameters on the sensor response to establish actionable correlations. Real-time assessment of wound healing was carried out through longitudinal monitoring of uric acid and other wound fluid characteristics. A textile sensor was designed using a simple fabrication approach combining conductive inks with a polymeric substrate, for conformal contact with the wound bed. A −1 cm−2, establishing the applicability of the sensor for measurements in the physiologically relevant range. The sensor was also found to be stable for a period of 3 days when subjected to physiological and elevated temperatures (37oC and 40oC) confirming its relevance for long-term monitoring. A direct correlation between sensor response and the dynamic parameters was seen, with the results showing a ~20% deviation from the accurate UA reading. The results confirmed that as a consequence of these parameters temporally changing in the wound environment, the sensor response will be altered. The work develops mathematical models correlating this effect on sensor response to allow for real-time sensor calibration. The clinical validation studies established the feasibility of UA measurement by the developed electrochemical sensor and derive correlations between the wound chronicity and UA levels. The protocols developed in this work for the design, fabrication, and calibration of the sensor to correct for the dynamic in vivo behavior can be extended to any wearable sensor for improved accuracy

Recent Advances in Wound Healing

The human wound-healing process could be divided into four discrete phases, which have also been indicated as the hemostasis, the inflammatory, the proliferation, and the remodeling phase. For a wound to be healed efficaciously, all four phases must sequentially happen at an expected time setting. Numerous aspects can hinder one or more stages of this procedure, thus can cause inappropriate or diminished wound healing. This book reviews the recent literature on the most significant factors that affect wound healing and the potential cellular and/or molecular mechanisms involved. The factors discussed include physiology of wound healing, interferon, stem cells and photobiomodulation, chronic venous ulcer, chronic fistula, bionanomaterials, topical antiseptic agents, including silver and sodium hypochlorite solution, diabetic ulcers, and nutritional supplements such as copper

Aplicación de técnicas de iluminación y procesado de imagen para la detección y medición de lesiones

Tesis por compendio[ES] En el presente trabajo se realiza un análisis completo de las técnicas de iluminación y registro de imagen desarrollados hasta el momento y que permiten emplear la fluorescencia intrínseca de estructuras biológicas para aumentar la capacidad de identificación, detección y análisis de lesiones y anomalías que puedan presentarse. El trabajo se ha enfocado principalmente en a) el análisis, validación y desarrollo de técnicas de detección precoz de lesiones asociadas al Carcinoma Escamoso Epidermoide (oncología otorrinolaringológica), así como posibles lesiones precursoras y b) el análisis y desarrollo de una metodología que permita registrar imágenes de fluorescencia y cuantificar mediante la aplicación de técnicas de procesado de imagen la afección provocada por el Acné Vulgaris (dermatología). Se proponen nuevas formas de adquisición, registro y procesado de imágenes de fluorescencia que mejoran de forma objetiva la capacidad de detección y gestión de las anteriores patologías. El desarrollo de la Tesis ha dado lugar a varios resultados. Parte de los resultados se han estructurado en forma de artículos de investigación y trabajos publicados en revistas JCR. Así, la tesis se va a desarrollar por Compendio de Artículos, incluyéndose: a) Artículo de Investigación 1 publicado en revista JCR. Segmentation methods for acne vulgaris images: Proposal of a new methodology applied to fluorescence images. b) Artículo de Investigación 2 publicado en revista JCR. Hough Transform Sensitivivy Factor Calculation Model Applied to the Analysis of Acné Vulgaris Skin Lesions. c) Artículo de Investigación publicado en Congreso Internacional. Analysis of segmentation methods for acne vulgaris images. Proposal of a new methodology applied to fluorescence images. d) Estudio Observacional (modalidad de ensayo clínico para técnicas no invasivas) con DICTAMEN FAVORABLE para su realización con fecha 29 de Septiembre de 2022. El Estudio Observacional ha sido evaluado por los miembros del Comité Ético de Investigación con medicamentos del Departamento Arnau de Vilanova-Llíria. A causa de la pandemia causada por la COVID-19, la ejecución del trabajo se ha visto pospuesta y se iniciará en el último trimestre de 2022. Título: ANÁLISIS DE IMÁGENES DE AUTOFLUORESCENCIA PARA SU USO POTENCIAL COMO SISTEMA NO INVASIVO EN LA DETECCIÓN DE LESIONES ORALES POTENCIALMENTE MALIGNAS. De forma adicional a los trabajos publicados, se ha redactado en forma de review (susceptible de ser publicado) el estado del arte que ha permitido desarrollar el OBJETIVO ESPECÍFICO 3. Se adjunta como Artículo de Investigación susceptible de publicación en revista JCR. Título: Segmentation of acne vulgaris images algorithms. La ejecución del Estudio Observacional se plantea como la línea de investigación a seguir y que da continuidad a la investigación iniciada en la presente Tesis Doctoral. El documento de Tesis está estructurado en 7 capítulos y 11 Anexos. Para el desarrollo del presente trabajo se han planteado tres objetivos específicos. Cada artículo o trabajo publicado se corresponde con el desarrollo de cada uno de los tres objetivos específicos. Así, cada uno de los capítulos 3, 4 y 5 plantea el escenario, desarrollo y conclusiones obtenidas que han dado como resultado cada uno de los trabajos publicados de forma independiente.[CAT] En el present treball es realitza una anàlisi completa de les tècniques d'il·luminació i registre d'imatge desenvolupats fins al moment i que permeten emprar la fluorescència intrínseca d'estructures biològiques per a augmentar la capacitat d'identificació, detecció i anàlisi de lesions i anomalies que puguen presentar-se. El treball s'ha enfocat principalment en a) l'anàlisi, validació i desenvolupament de tècniques de detecció precoç de lesions associades al Carcinoma Escatós Epidermoide (oncologia otorrinolaringològica), així com possibles lesions precursores i b) l'anàlisi i desenvolupament d'una metodologia que permeta registrar imatges de fluorescència i quantificar mitjançant l'aplicació de tècniques de processament d'imatge l'afecció provocada per l'Acne Vulgaris (dermatologia). Es proposen noves formes d'adquisició, registre i processament d'imatges de fluorescència que milloren de manera objectiva la capacitat de detecció i gestió de les anteriors patologies. El desenvolupament de la Tesi ha donat lloc a diversos resultats. Part dels resultats s'han estructurat en forma d'articles d'investigació i treballs publicats en revistes JCR. Així, la tesi es desenvoluparà per Compendi d'Articles, incloent-se: a) Article d'Investigació 1 publicat en revista JCR. Segmentation methods for acne vulgaris images: Proposal of a new methodology applied to fluorescence images. b) Article d'Investigació 2 publicat en revista JCR. Hough Transform Sensitivivy Factor Calculation Model Applied to the Analysis of Acné Vulgaris Skin Lesions. c) Article d'Investigació publicat en Congrés Internacional. Analysis of segmentation methods for acne vulgaris images. Proposal of a new methodology applied to fluorescence images. d) Estudi Observacional (modalitat d'assaig clínic per a tècniques no invasives) amb DICTAMEN FAVORABLE per a la seua realització amb data 29 de Setembre de 2022. L'Estudi Observacional ha sigut avaluat pels membres del Comité Ètic d'Investigació amb medicaments del Departament Arnau de Vilanova-Llíria. A causa de la pandèmia causada per la COVID-19, l'execució del treball s'ha vist posposada i s'iniciarà en l'últim trimestre de 2022. Títol: ANÁLISIS DE IMÁGENES DE AUTOFLUORESCENCIA PARA SU USO POTENCIAL COMO SISTEMA NO INVASIVO EN LA DETECCIÓN DE LESIONES ORALES POTENCIALMENTE MALIGNAS. De manera addicional als treballs publicats, s'ha redactat en forma de review (susceptible de ser publicat) l'estat de l'art que ha permés desenvolupar l'OBJECTIU ESPECÍFIC 3. S'adjunta com a Article d'Investigació susceptible de publicació en revista JCR. Títol: Segmentation of acne vulgaris images algorithms. L'execució de l'Estudi Observacional es planteja com la línia d'investigació a seguir i que dona continuïtat a la investigació iniciada en la present Tesi Doctoral. El document de Tesi està estructurat en 7 capítols i 11 Annexos. Per al desenvolupament del present treball s'han plantejat tres objectius específics. Cada article o treball publicat es correspon amb el desenvolupament de cadascun dels tres objectius específics. Així, cadascun dels capítols 3, 4 i 5 planteja l'escenari, desenvolupament i conclusions obtingudes que han donat com a resultat cadascun dels treballs publicats de manera independent.[EN] In the present work, a complete analysis is made of the illumination and image recording techniques developed so far that allow the use of intrinsic fluorescence of biological structures to increase the capacity of identification, detection and analysis of lesions and anomalies that may occur. The work has focused mainly on a) the analysis, validation and development of techniques for the early detection of lesions associated with Squamous Epidermoid Carcinoma (otorhinolaryngological oncology), as well as possible precursor lesions, and b) the analysis and development of a methodology for recording fluorescence images and quantifying the condition caused by Acne Vulgaris (dermatology) through the application of image processing techniques. New ways of acquisition, registration and processing of fluorescence images are proposed to objectively improve the capacity of detection and management of the previous pathologies. The development of the Thesis has led to several results. Part of the results have been structured in the form of research articles and papers published in JCR journals. Thus, the thesis is going to be developed by Compendium of Articles, including: a) Research Article 1 published in JCR journal. Segmentation methods for acne vulgaris images: Proposal of a new methodology applied to fluorescence images. b) Research Article 2 published in JCR journal. Hough Transform Sensitivity Factor Calculation Model Applied to the Analysis of Acne Vulgaris Skin Lesions. c) Research Article published in International Congress. Analysis of segmentation methods for acne vulgaris images. Proposal of a new methodology applied to fluorescence images. d) Observational study (clinical trial modality for non-invasive techniques) with FAVORABLE OPINION for its realization on September 29, 2022. The Observational Study has been evaluated by the members of the Ethics Committee for Research with Medicines of the Arnau de Vilanova-Llíria Department. Due to the pandemic caused by COVID-19, the execution of the work has been postponed and will start in the last quarter of 2022. Title: ANALYSIS OF AUTOFLUORESCENCE IMAGES FOR POTENTIAL USE AS A NON-INVASIVE SYSTEM IN THE DETECTION OF POTENTIALLY MALIGNANT ORAL LESIONS. In addition to the published works, the state of the art that has allowed the development of SPECIFIC OBJECTIVE 3 has been written in the form of a review (susceptible of being published). It is attached as a Research Article susceptible of being published in a JCR journal. Title: Segmentation of acne vulgaris images algorithms. The execution of the Observational Study is proposed as the line of research to be followed and which gives continuity to the research initiated in the present Doctoral Thesis. The Thesis document is structured in 7 chapters and 11 Annexes. Three specific objectives have been set for the development of this work. Each article or published work corresponds to the development of each of the three specific objectives. Thus, each of the chapters 3, 4 and 5 presents the scenario, development and conclusions obtained that have resulted in each of the works published independently.Moncho Santonja, M. (2022). Aplicación de técnicas de iluminación y procesado de imagen para la detección y medición de lesiones [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/191027Compendi