Skin imaging: is it clinically useful?

Yes ! that is a great title for a very serous paper.  Skin imaging: is it clinically useful?

Kudos to Dr. Deepack Rallan of the Department of Dermatology at the St Helier's Hospital (South London, Surrey, UK) for asking the right question and providing a documented and good discussion in his paper published in the Journal of experimental dermatology ( Sept 2004). Granted..it is not a "recent" paper. But the discussion and fundamentals are still up to date. Let me quote the abstract below: ( online abstract and author contact details here)

Abstract

Non-invasive skin imaging techniques have proliferated over the last decade. Whilst most have a research role, some are routinely used in dermatology clinics. Of these, the skin surface microscope (dermatoscope), a diagnostic aid for pigmented lesions, has had most clinical impact. Such devices, when linked to a videomicroscope for computer analysis, have been dubbed as 'mole scanners'. Mole scanners are increasingly available on a commercial basis even though computer diagnosis of pigmented lesions is currently no better than diagnosis by human experts. Meanwhile, other imaging techniques, such as high-resolution ultrasonography, spectroscopy and optical coherence tomography, may yet find a role in diagnosis and disease monitoring.

Complexion Imaging: the 7th Generation

This is not like the "7th Generation" of the Star Wars Series. We are talking about the sophisticated  VISIA Complexion Analysis from CANFIELD, who are now in its 7th product iteration.

The renowned company is making a complicated and tricky process (believe it or not, a robust face and complexion image is very tricky to do) into a very user-friendly system.

Standardized images required a very sophisticated imaging methodology, which includes standardized lighting (yes... including polarization and frequencies !!!) and image capture parameters. This is particularly critical when post-imaging image analysis is part of the package. Otherwise...how is is the comparison relevant.

Some of the multiple image post-analysis features offered by the company are very nice, and are relevant in practice. Other are really borderline.... like the "eyelash" analysis. Seriously?? who is ready to pay for this.

Well, we really like the product.
Is this only for cute white caucasian ladies as featured on their website. I would suggest a more diverse view of the market and marketing positioning (or is the product not capable to work on dark or asian skins ?). Hmmmm ?

New Book: "Imaging in Dermatology"

"Imaging in Dermatology" edited by Drs Michael R.Hamblin, Pinar Avci and Gaurav K.Gupta (ISBN: 978-0-12-802838-4) is a 2016 ELSEVIER publication that all the readers of this blog should be aware of.
I just ordered the book on Amazon for $120, and I can't wait to ready it and perhaps interview the authors (stay tuned). Congrats to the all the contributing Authors, Editors and ELSEVIER for their interest and work on the topic.

The table of content is rich and comprehensive (see Preview on Google Books here): 

2. Role of Clinical Photography in Dermatology

3. Dermoscopy

4. Trichoscopy: the Dermatologist's Third Eye

5. Dermatoscopy Correlates of Nail Appartus Disease

6. Optical Coherence Tomography (OCT) for Skin Cancer and Actinic Keratosis

7. OCT of Skin Scarring and Fibrosis

8. Polarization Speckles and Skin Applications

9. New Developments in Fluorescence Diagnostics

10. Ex-vivo Fluorescence Microscopy: Clinical Applications

11. Coherent Raman Scattering Microscopy in Dermatological Imaging

12.  Rapid Real-time Raman Spectroscopy and Imaging-Guided Confocal Raman Spectroscopy

13. Surface-Enhanced Raman Spectroscopy for Intradermal Measurements

14. Broadband Coherent Anti-Stokes Raman Scattering

15. In-Vivo Reflectance Confocal Microscopy (in Dematology)

16. Hyperspectral and Multispectral Imaging in Dermatology

17. Diffuse Reflectance Spectroscopy and Imaging

18. Spectral Imaging  in Dermatology

19. Applications of MultiPhoton Microscopy in Dermatology

20. Non-linear Microscopy in Clinical Dermatology

21. Confocal Reflectance Microscopy and Polarized Light Imaging

22. Polarization optical Imaging of Skin Pathology and Ageing

23. Surface Acoustic Waves

24. Photoacoustic Tomography in the diagnosis of Melanoma

25. Ultrasound imaging in Dermatology

26. Optoacoustic Imaging of Skin

27. Total Body Photography and serial Digital Dermoscopy

28.  Functional MRI behind the processing of itch (note: "?? WTH?")

...

30. Thermal Imaging in Dermatology

...

34. Imaging in Merkel Cell Carcinoma

35. Imaging Evaluation of Cutaneous Lymphoma using Functional and Structural Imaging

36. Imaging Cutaneous Squamous Cell Carcinoma of the Head and Neck

37. Imaging Patterns of Metastatic Melanoma

38. From Image to information: image Processing in dermatology and Cutaneous Biology.

(Good luck to the Google search engine to index my blog!!  will this create more traffic?)

OKU : Personal Skin Coach : is it real?

OKU Claims to be the first iPhone enabled Personal Skin Coach, and is now taking pre-orders on line.

The idea of an iPhone connected imaging interface that addresses the major challenges of reproducible and quantified skin imaging is definitely attractive, and there is a market for that..

But OKU's technology platform remains a big mystery. For engineers, the "OKU Technology" tab on the company website is simply disappointing. Name dropping "dermoscopy", "nanotechnology" and "spectroscopy" just alone simply does not work for us. Indeed, the potential of such technologies can be fantastic.... please tell us more! Show us how it works ( a little movie maybe ?) ... this is how you will make a difference as skin imaging is not trivial.

Having said that, and despite the cute but disappointing "marketing packaging" of the entire website (and lack of real product pictures, images and data), there are several product features that are quite attractive, including the portable imaging device and its docking station (please convince me that this is not "just" a webcam) and the simple and effective design of the iPhone App.

So in short....taking pre-orders at $249.95 for a due-date of "late Spring 2015" is a very aggressive call, and will probably convince grand parents who want to make a graduation present to their high-school grand-daughter with chronic acne. 

Please let's be serious.... show us a real product, explain your technology, show us real data and pictures to be more convincing. there is a lot going on in this industry and we all expect more fro a incoming player.

Google alerts are active on "OKU". We shall see.

French Start up ANAPIX Tackles the Holy Grail

French Start-up ANAPIX is currently incubated by the Technology Accelerator and incubator or Mareilles and has ambitious plans to takle the Holi Grail: a iPhone enabled image capture system...coupled to cloud-based image analysis and calculators to offer Clinical Decision support to dermatologists for the Skin cancer.

This is a very ambitious project, will challenges all along the technology workflow... and the care and regulatory trajectories.  A dozen of dermatologists are piloting the system in France.

ANAPIX is current;y looking for partners to take the concept to the next steps. Please reach out to them via www.sattse.com

"SKINSPECTION" – Hybrid Imaging for Skin Diagnosis

The "SKINSPECTION" approach combines two-photon imaging with time-correlated single photon detection, autofluorescence lifetime imaging, high-frequency ultrasound and optoacoustic imaging. 

The innovative combination of these modalities allows to obtain a wide-field view with quantitative depth information of skin lesions and a close-look into particular intra-tissue compartments with quantitative hyperspectral information and subcellular resolution. The goal of the project is to provide a novel unique tool for early diagnosis and treatment control of skin cancer and skin disease. For achieving this objective, two systems for microscopic and macroscopic imaging of lesions were developed in the last 3 years by the partners JenLab GmbH and Imperial College London (two-photon microscopy/FLIM) and Fraunhofer IBMT (Fraunhofer Institute for Biomedical Engineering) and kibero GmbH (optoacoustic/ultrasound imaging). 

The systems were successfully certified for clinical studies and are currently being evaluated for imaging of skin lesions in a bicentric clinical trial at Hammersmith Hospital and Universita di Modena.

Check for the full research project description on the Europe FP7 webportal.

SCHOTT skin counseling system

(Launched Sept 9th 2013) 

SCHOTT skin counseling systems are used by international cosmetic manufacturers as marketing tools. The new i-Scope® Viewer for AndroidTM was developed to achieve a more handy counseling method using tablet computers. The product is now available on Google Play™ (!! Cool!)  in three languages: English, Japanese and Chinese.

i-Scope® Viewer for Android™ is the fitting software for i-Scope® USB 2.0. The program allows users to easily observe their skin conditions in detail: by moving the scope along their skin, shooting images and saving them, comparing two images in one screen or viewing multiple saved images simultaneously. i-Scope® USB 2.0 is a scope equipped with a 1.3 mega CMOS sensor that can be used to observe skin, scalp and hair conditions by connecting the USB cable to a computer. Five lens options are available. 

Features of i-Scope® USB 2.0 Android™ and specification of i-Scope® Viewer for Android™

•Connection: Wired (mini-USB cables sold separately)
•No additional setting necessary on tablet PC; easy connection 
•Stable view of moving pictures 
•Compatible devices: Versions after Android ver. 3.2 are USB host capable (except for some devices) 
•Can check skin conditions by shooting still images 
•Can display two images in one screen. Can check different parts of the skin 
•Can save displayed images 
•Can display multiple saved images 
•Available in English, Japanese and Chinese 

More on the Manufacturer's website here.