Accurate wide field machine assessment of Acne and Rosacea S Cotton1 and R Marks2 1Astron Clinica, UK 2University of Cardiff, UK

Aims To assess the possibility of quantifying the degree and severity of acne and rosacea using a novel device based on the SIAscope.

Overview To describe benefits of quantifying the degree and severity of acne and rosacea To review previous attempts at measuring these disorders To describe our preliminary studies and comment To suggest ways forward and conclude

Difficulties in monitoring acne Difficult to define area Difficult to count lesions Wide scatter of data when counting attempted

Requirements of a method to quantify acne Production of accurate reproducible data concerning the severity and extent of disease Method is simple, convenient and cheap Data derived is numeric and has linear relationship with clinical assessment

Previous methodologies to assess acne and rosacea (1) Clinical “Global” e.g. Nill, mild, moderate, moderately severe, sever, very severe “Spot counting” (more difficult than it sounds!) “Grading” (Leeds system matching with standard photograph)

Previous methodologies to assess acne and rosacea (2) Photographic Quite difficult as total standardisation required! Photograph scored at end of study Digital image analysis based on UV fluorescence and colour contrast

Benefits of quantifying Acne and Rosacea Would provide accurate patient record at one time point Essential for assessing effects of treatment Should enable better understanding of diseases

SIAscope principle R B G The SIAscope is a multi spectral imaging device for examining the skin. Links histological parameters (haemoglobin, melanin and collagen) to a reflectance spectrum Uses broadband spectroscopy to measure reflectance spectrum of skin B R Collagen Haemoglobin Reflectance spectrum Melanin G

SIAscope camera SIATMMeter Original SIAscope requires contact with the skin limiting the area under investigation to 11 by 11 mm The SIATMMeter utilizes new non-contact SIA technology to allow investigation of haemoglobin and melanin over wide areas Lack of contact removes blood blanching effect of using contact SIAscope

SIAscope camera SIATMMeter Can be implemented with a standard camera and calibrated light source, such as a flash gun. Reliably and reproducibly quantifies haemoglobin and melanin regardless of lighting, patient distance or setup

Patient 1- Acne Stage 1: SIAblood image computed Colour image

Patient 1- Acne Stage 2: Acne lesions automatically identified from SIAblood image Extent and inflammation automatically calculated and recorded SIAblood image with acne lesions identified Colour image with acne lesions overlaid

Patient 2- Acne SIAblood image with acne lesions identified Colour image with acne lesions overlaid

Results 15 Patients imaged with the SIATMMeter and clinically scored for Acne extent Good correlation found between clinical scoring for acne extent and automatically measured SIATMMeter value R2=0.8 Good correlation found between clinical global scoring and combination of SIATMMeter measured extent and inflamation R2=0.82

Data

Patient 3- Rosacea Extent and inflamation can also be calculated for rosacea patients to assist in the monitoring of treatment SIAblood image where extent of rosacea can be clearly seen Colour image

Summary The importance of quantifying acne and rosacea has been recognized The SIAscope principle has been embedded in a new device called the SIATMMeter The SIATMMeter has been used to investigate patients with acne and rosacea. A good correlation between the SIATMMeter data and clinical evaluation has been obtained.

Future work Further patients will be investigated using the principles described here It is intended to develop both the hardware and software so that the device will be fully automated and produce results instantly Thanks to R Morse of Astron Clinica for assistance with data collection and processing