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A novel noncontact widefield analytical spectroholometric device (the siameter) for the evaluation of skin disorders
P1101
P1103
A NOVEL NONCONTACT WIDEFIELD ANALYTICAL SPECTROHOLOMETRIC DEVICE (THE SIAMETER) FOR THE EVALUATION OF SKIN DISORDERS Professor Ronald Marks, Cutest Systems Ltd, Cardiff, Wales; Simon Cotton, PhD, Aston Clinica, Wales
INTERNET USE BY DERMATOLOGY PATIENTS IN LANARKSHIRE, SCOTLAND: A LOCAL SURVEY Vandana Ramrakha-Jones, MBChB, Girish Gupta, MBBCh, Monklands Hospital, Airdrie, Scotland
A simple objective method for obtaining quantitative data of skin lesions in real time would be of enormous value to clinicians and clinical trialists. We have utilized the same principle as that used in the Siascope 1.2., in which light returned from the skin is investigated by quantitative spectroscopy. The present device known as the Siameter uses a carefully calibrated digital camera equipped with a modified ring flash with specialized filter and dedicated software. The system is able to evaluate a wide range of areas of skin entirely dependent on the camera optics chosen. To investigate the potential of the Siameter we have studied patients with acne, rosacea, and psoriasis. The parameters chosen to assess the patients were either non-disease specific or disease specific. Among the non-disease-specific parameters chosen were the number of lesions present in the field chosen (NL), the area covered by the lesions (ACL), and the mean erythema intensity of lesions (MEIL). Among the disease-specific parameters chosen were the number of lesions on the half face (LHF) and the number of inflamed lesions on the half face (ILHF). A wide range of areas of the body surface can be studied from 5 mm2 to half-body images. In patients with psoriasis the NL, ACL, and MEIL were particularly useful, and for patients with acne and rosacea the LHF and ILHF were more appropriate.
The use of the Internet by patients seeking health information is on the increase. However, its use is a double-edged sword; although the Internet is a vast and instant resource, the information obtained may be incomplete, biased, or confusing.
The Siameter will be of great help in both patient care and in clinical trials of dermatological pharmaceutical products.
Bibliography Moncrieff M, Cotton S, Claridge E, et al. Spectrophotometric intracutaneous analysis: a new technique for imaging pigmented skin lesions. Br J Dermatol 2002;146:448-57. Preece S, Cotton S, Claridge E. Imaging the pigments of human skin with a technique which is invariant to changes in surface geometry and intensity of illuminating light. Medical Image Understanding & Analysis 2003.
Our objectives were to find out what proportion of patients attending our dermatology clinics had access to the Internet, whether they had used it for their skin problem, and whether they had found it useful. Questionnaires were given to patients attending the outpatient clinics in two Lanarkshire hospitals during April 2004. One hundred fifty-six completed questionnaires were collected and analyzed. One hundred sixteen of 156 patients (74%) had access to the Internet, and 51 of 156 (44%) used it daily, with the rest using it less often. Most had access through home and/or work. The most common reasons for Internet use were holidays (72/156) and travel (77/156). However, 43 of 156 had also used it for information about their skin problem and 35 of 156 had used it for other health issues. Of the proportion that had used it for their skin problem, although 77% (33/43) found it useful, the majority (77%; 33/43) did not find it more useful than speaking to a doctor in the clinic. When asked how they would prefer to receive further information about their skin, the majority (69/156) would still prefer face-to-face consultation with a doctor, although a significant proportion would also prefer information in writing (52/156) or via the Internet (45/156). This survey is the first of its kind in UK dermatology. Although it has reassuringly shown that patients still find one-to-one consultations with the doctor most useful, it has also emphasized that many will turn to the Internet for extra information. If we, as physicians, can guide their Internet searches by recommending relevant and informative Web sites, we will be keeping abreast of the times and empowering patients to take an active role in their disease management. Nothing to disclose.
Nothing to disclose.
P1104
P1102 COMPARATIVE EVAPORIMETRY IN HUMANS Hongbo Zhai, MD, Jigna Shah, MD, Howard Maibach, MD, University of California, San Francisco, San Francisco, CA, United States
TELEDERMATOLOGY IN THE ISRAELI DEFENSE FORCES: QUALITY ASSESSMENT THROUGH USER SATISFACTION Itay Klaz, MD, Yonit Wohl, MD, Nir Nathanson, MD, Israeli Defense Forces, Tel Aviv, Israel; Sarah Brenner, MD, Tel Aviv Sourasky Medical Center, Department of Dermatology, Tel Aviv, Israel Objective: To assess the effect of a computerized store-and-forward teledermatology (CSAFTD) service upon user (patients and primary care physicians [PCPs]) satisfaction in the Israeli Defense Forces (IDF).
Conclusion: The TEWL values measured by all instruments were constant, with small standard deviations. These instruments appear sufficiently robust that a standardization group could document similarities and differences with in vitro models. We suspect that both techniques will continue to be used and that the closed method will find increasing use because of its ease of use.
Methods: The CSAFTD service was implemented in 10 remote rural and 8 urban military clinics. Each patient was examined by the clinic’s PCP who recorded the medical history on a prospectively designed dermatological questionnaire. Digital photographs of skin lesions were taken by a trained medic and e-mailed to a Boardcertified dermatologist who responded by e-mail with diagnosis and therapeutic advice. Patients were asked to complete a satisfaction questionnaire 1 month later, evaluating accessibility, attitude of caretakers, respect for privacy, health improvement, drug availability, and overall satisfaction on a scale of 0 (low) to 5 (very high). PCPs were asked after each consultation to complete a satisfaction questionnaire evaluating accessibility, personal knowledge improvement, and overall satisfaction. Results: Four hundred thirty-five patients were referred for CSAFTD. Three hundred thirty-nine (78%) were managed by CSFAFTD alone, without need for further face-toface evaluation. Common diagnoses made through the system were pityriasis versicolor (17%), onychomycosis (16%), acne vulgaris (14%), tinea corporis (13%), folliculitis (10%), and atopic dermatitis (7%). The average referral rate to CSAFTD was 14% in large, centrally located clinics and 62% in remote rural clinics. Average time spent between PCP examination and initiation of treatment using CSAFTD was 72 hours. Patient satisfaction with CSAFTD was very high in both remote and central clinics, with 88.5% of patients giving the items a score of 4 or 5. With regard to accessibility, CSAFTD was scored 4 or 5 by 82.9% of patients. PCPs were also very satisfied with the CSAFTD, both in terms of improvement in the quality of health care (scores of 4 or 5 in 87% of the cases) and improvement in dermatology knowledge (scores of 4 or 5 in 61% of cases). Conclusions: Store-and-forward teledermatology improves quality of care in both remote rural clinics and centrally located urban clinics in the IDF. Large-scale implementation of a CSAFTD service is planned.
Nothing to disclose.
Nothing to disclose.
Background/aims: Transepidermal water loss (TEWL) measurements are frequently used; the most widely utilized instrument has been the Tewameter, based on the open chamber method. Traditional open chamber systems for measuring TEWL have limitations related to ambient and body-induced airflows near the probe, probe size, measurement site, and angles. Recent technology provides a portable and battery-operated closed chamber Evaporimeter. It is presumably unaffected by external factors such as room or body-induced airflows, breathing, or heating of the probe by the operator’s hand. This study compares this commercial instrument, a closed chamber device, with a traditional open-chamber device. Methods: Two Tewameters and one Vapometer were used in such a way that each instrument could simultaneously measure TEWL in an identical experimental environment with known relative humidity and temperature values. TEWL values of 7 locations on healthy volunteers were measured simultaneously with each instrument in the same room according to the guidelines of the standardization group of the European Society of Contact Dermatitis. Results: For TEWL values of all forearm locations, there was not a statistically significant difference between the mean values measured by all 3 instruments. For TEWL values of forehead locations, there was a significant difference between the mean values of the Tewameter and the Vapometer. For the forehead, Vapometer values were higher than those of the Tewameter.
P98
J AM ACAD DERMATOL
MARCH 2005
P1103
A NOVEL NONCONTACT WIDEFIELD ANALYTICAL SPECTROHOLOMETRIC DEVICE (THE SIAMETER) FOR THE EVALUATION OF SKIN DISORDERS Professor Ronald Marks, Cutest Systems Ltd, Cardiff, Wales; Simon Cotton, PhD, Aston Clinica, Wales
INTERNET USE BY DERMATOLOGY PATIENTS IN LANARKSHIRE, SCOTLAND: A LOCAL SURVEY Vandana Ramrakha-Jones, MBChB, Girish Gupta, MBBCh, Monklands Hospital, Airdrie, Scotland
A simple objective method for obtaining quantitative data of skin lesions in real time would be of enormous value to clinicians and clinical trialists. We have utilized the same principle as that used in the Siascope 1.2., in which light returned from the skin is investigated by quantitative spectroscopy. The present device known as the Siameter uses a carefully calibrated digital camera equipped with a modified ring flash with specialized filter and dedicated software. The system is able to evaluate a wide range of areas of skin entirely dependent on the camera optics chosen. To investigate the potential of the Siameter we have studied patients with acne, rosacea, and psoriasis. The parameters chosen to assess the patients were either non-disease specific or disease specific. Among the non-disease-specific parameters chosen were the number of lesions present in the field chosen (NL), the area covered by the lesions (ACL), and the mean erythema intensity of lesions (MEIL). Among the disease-specific parameters chosen were the number of lesions on the half face (LHF) and the number of inflamed lesions on the half face (ILHF). A wide range of areas of the body surface can be studied from 5 mm2 to half-body images. In patients with psoriasis the NL, ACL, and MEIL were particularly useful, and for patients with acne and rosacea the LHF and ILHF were more appropriate.
The use of the Internet by patients seeking health information is on the increase. However, its use is a double-edged sword; although the Internet is a vast and instant resource, the information obtained may be incomplete, biased, or confusing.
The Siameter will be of great help in both patient care and in clinical trials of dermatological pharmaceutical products.
Bibliography Moncrieff M, Cotton S, Claridge E, et al. Spectrophotometric intracutaneous analysis: a new technique for imaging pigmented skin lesions. Br J Dermatol 2002;146:448-57. Preece S, Cotton S, Claridge E. Imaging the pigments of human skin with a technique which is invariant to changes in surface geometry and intensity of illuminating light. Medical Image Understanding & Analysis 2003.
Our objectives were to find out what proportion of patients attending our dermatology clinics had access to the Internet, whether they had used it for their skin problem, and whether they had found it useful. Questionnaires were given to patients attending the outpatient clinics in two Lanarkshire hospitals during April 2004. One hundred fifty-six completed questionnaires were collected and analyzed. One hundred sixteen of 156 patients (74%) had access to the Internet, and 51 of 156 (44%) used it daily, with the rest using it less often. Most had access through home and/or work. The most common reasons for Internet use were holidays (72/156) and travel (77/156). However, 43 of 156 had also used it for information about their skin problem and 35 of 156 had used it for other health issues. Of the proportion that had used it for their skin problem, although 77% (33/43) found it useful, the majority (77%; 33/43) did not find it more useful than speaking to a doctor in the clinic. When asked how they would prefer to receive further information about their skin, the majority (69/156) would still prefer face-to-face consultation with a doctor, although a significant proportion would also prefer information in writing (52/156) or via the Internet (45/156). This survey is the first of its kind in UK dermatology. Although it has reassuringly shown that patients still find one-to-one consultations with the doctor most useful, it has also emphasized that many will turn to the Internet for extra information. If we, as physicians, can guide their Internet searches by recommending relevant and informative Web sites, we will be keeping abreast of the times and empowering patients to take an active role in their disease management. Nothing to disclose.
Nothing to disclose.
P1104
P1102 COMPARATIVE EVAPORIMETRY IN HUMANS Hongbo Zhai, MD, Jigna Shah, MD, Howard Maibach, MD, University of California, San Francisco, San Francisco, CA, United States
TELEDERMATOLOGY IN THE ISRAELI DEFENSE FORCES: QUALITY ASSESSMENT THROUGH USER SATISFACTION Itay Klaz, MD, Yonit Wohl, MD, Nir Nathanson, MD, Israeli Defense Forces, Tel Aviv, Israel; Sarah Brenner, MD, Tel Aviv Sourasky Medical Center, Department of Dermatology, Tel Aviv, Israel Objective: To assess the effect of a computerized store-and-forward teledermatology (CSAFTD) service upon user (patients and primary care physicians [PCPs]) satisfaction in the Israeli Defense Forces (IDF).
Conclusion: The TEWL values measured by all instruments were constant, with small standard deviations. These instruments appear sufficiently robust that a standardization group could document similarities and differences with in vitro models. We suspect that both techniques will continue to be used and that the closed method will find increasing use because of its ease of use.
Methods: The CSAFTD service was implemented in 10 remote rural and 8 urban military clinics. Each patient was examined by the clinic’s PCP who recorded the medical history on a prospectively designed dermatological questionnaire. Digital photographs of skin lesions were taken by a trained medic and e-mailed to a Boardcertified dermatologist who responded by e-mail with diagnosis and therapeutic advice. Patients were asked to complete a satisfaction questionnaire 1 month later, evaluating accessibility, attitude of caretakers, respect for privacy, health improvement, drug availability, and overall satisfaction on a scale of 0 (low) to 5 (very high). PCPs were asked after each consultation to complete a satisfaction questionnaire evaluating accessibility, personal knowledge improvement, and overall satisfaction. Results: Four hundred thirty-five patients were referred for CSAFTD. Three hundred thirty-nine (78%) were managed by CSFAFTD alone, without need for further face-toface evaluation. Common diagnoses made through the system were pityriasis versicolor (17%), onychomycosis (16%), acne vulgaris (14%), tinea corporis (13%), folliculitis (10%), and atopic dermatitis (7%). The average referral rate to CSAFTD was 14% in large, centrally located clinics and 62% in remote rural clinics. Average time spent between PCP examination and initiation of treatment using CSAFTD was 72 hours. Patient satisfaction with CSAFTD was very high in both remote and central clinics, with 88.5% of patients giving the items a score of 4 or 5. With regard to accessibility, CSAFTD was scored 4 or 5 by 82.9% of patients. PCPs were also very satisfied with the CSAFTD, both in terms of improvement in the quality of health care (scores of 4 or 5 in 87% of the cases) and improvement in dermatology knowledge (scores of 4 or 5 in 61% of cases). Conclusions: Store-and-forward teledermatology improves quality of care in both remote rural clinics and centrally located urban clinics in the IDF. Large-scale implementation of a CSAFTD service is planned.
Nothing to disclose.
Nothing to disclose.
Background/aims: Transepidermal water loss (TEWL) measurements are frequently used; the most widely utilized instrument has been the Tewameter, based on the open chamber method. Traditional open chamber systems for measuring TEWL have limitations related to ambient and body-induced airflows near the probe, probe size, measurement site, and angles. Recent technology provides a portable and battery-operated closed chamber Evaporimeter. It is presumably unaffected by external factors such as room or body-induced airflows, breathing, or heating of the probe by the operator’s hand. This study compares this commercial instrument, a closed chamber device, with a traditional open-chamber device. Methods: Two Tewameters and one Vapometer were used in such a way that each instrument could simultaneously measure TEWL in an identical experimental environment with known relative humidity and temperature values. TEWL values of 7 locations on healthy volunteers were measured simultaneously with each instrument in the same room according to the guidelines of the standardization group of the European Society of Contact Dermatitis. Results: For TEWL values of all forearm locations, there was not a statistically significant difference between the mean values measured by all 3 instruments. For TEWL values of forehead locations, there was a significant difference between the mean values of the Tewameter and the Vapometer. For the forehead, Vapometer values were higher than those of the Tewameter.
P98
J AM ACAD DERMATOL
MARCH 2005