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

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

3. 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

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

5. 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

6. 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)

7. 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

8. 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

9. 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

10. 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

11. 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

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

13. 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

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

15. 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

17. Data

18. 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

19. 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.

20. 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