Computer-assisted alignment and tracking of acne lesions indicate that most inflammatory lesions arise from comedones and de novo  Thy Thy Do, MBBS, Semyon.

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Computer-assisted alignment and tracking of acne lesions indicate that most inflammatory lesions arise from comedones and de novo  Thy Thy Do, MBBS, Semyon Zarkhin, MD, Jeffrey S. Orringer, MD, Shari Nemeth, MD, Ted Hamilton, MS, Dana Sachs, MD, John J. Voorhees, MD, Sewon Kang, MD  Journal of the American Academy of Dermatology  Volume 58, Issue 4, Pages 603-608 (April 2008) DOI: 10.1016/j.jaad.2007.12.024 Copyright © 2008 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 The process by which the digital program aligns the photographs is illustrated by the following sequence of images: A, Week 0 photograph: Red dots represent anatomic landmarks chosen as alignment points to match those in week 12 photograph. B, Week 12 photograph with same anatomic landmarks in green. This photograph was used as the template to align all photographs in the patient's series (weeks 0, 2, 4, 6, 8, 10). C, Without digital alignment: photographs of week 0 and week 12 were superimposed (50/50 layer) to illustrate mismatching of anatomic landmarks. Despite standardized photographic techniques, serial photographs do not perfectly align. D, With digital alignment: photographs of week 0 and week 12 were superimposed (50/50 layer) to illustrate precise matching of photographs, ensuring accuracy with lesion tracking. Note: Alignment points in the digital program cannot be saved after the photograph has been aligned. Therefore the red and green dots were redrawn after the alignment to allow visualization of landmarks and to illustrate the technique used. Journal of the American Academy of Dermatology 2008 58, 603-608DOI: (10.1016/j.jaad.2007.12.024) Copyright © 2008 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 After all photographs in a patient's series have been aligned by the digital program, a region of interest (ROI) with the most clinically significant acne lesions was selected from either the temple or cheek to minimize reflective glare and shadowing. A, Week 0 photograph after alignment. White box indicates ROI. B, ROI at weeks 0, 2, 4, 6, 8, 10, 12 for our patient was printed on A4 photographic paper as a template to count and characterize lesion types as well as to track individual inflammatory lesions over time. Journal of the American Academy of Dermatology 2008 58, 603-608DOI: (10.1016/j.jaad.2007.12.024) Copyright © 2008 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Frequency for each type of lesion was averaged across 12 weeks for 25 patients to obtain a single estimate. Inflamm., Inflammatory. Journal of the American Academy of Dermatology 2008 58, 603-608DOI: (10.1016/j.jaad.2007.12.024) Copyright © 2008 American Academy of Dermatology, Inc. Terms and Conditions