Quantitation of epidermal and mucosal tissue injury using contrast agents and imaging techniques
Marty O Visscher1, David Sullivan, Steven Sullivan
1Cincinnati Children's Hospital Medical Center, The Skin Sciences Institute, Cincinnati, OH 45229, USA. marty.visscher@cchmc.org
Background/Purpose:
Epidermal injury is common but the accuracy of visual methods is significantly impacted by the inherent skin pigmentation. We examined imaging and fluorescence techniques to quantify tissue injury as a function of skin color.
Methods:
Epidermal and mucosal scratches were created in 20 light- (L(*) 68.2+/-2.3) and 20 dark-skinned (L(*) 46.4+/-5.2) females. Injured and uninjured sites were treated with toluidine blue (TB), fluorescein (FL) and a TB/FL mixture and photographed under conditions of white and fluorescent light. Area and intensity parameters were determined.
Results:
Injured sites with TB and TB/FL had higher areas than the control for both light and dark subjects (ANOVA, P<0.05). The intensity of the injured TB site was higher than the control for light skin only. The areas of injured sites with FL and TB/FL were higher than the control for both groups as were the intensities of the injured sites with FL. The findings were similar for the lip skin.
Conclusions:
Application of TB and FL contrasts under white and fluorescent light can be used to quantify tissue injuries for L(*) values >35 and is a promising approach for the quantitation across a range of skin pigmentation.
