Main Article Content
digital health, chronic skin disease, inflammatory skin disease, objective measurements
Introduction: Currently there are no portable solutions to robustly document and longitudinally monitor dynamically changing chronic skin conditions. This study set out to engineer and test a mobile-based 3D imaging solution for chronic skin diseases to enhance clinical workflow and patient care.
Methods: SkinSpecs uses smartphone-captured videos of patients’ skin disease and renders 3D true-to-life models that were evaluated by Stanford Health Care dermatologists.
Results: We utilized video input to accurately reconstruct interactive 3D models of 16 different skin conditions from 31 patients. Assessment of SkinSpecs 3D reconstruction is faster (p<0.05) compared to descriptive exam, standard photographs or original videos. Dermatologists maintained highest accuracy, confidence and satisfaction with 3D reconstruction. Dermatologist preferred SkinSpecs for documentation over other capture modalities. SkinSpecs was favorably used by dermatologists, with high satisfaction with resolution, breadth of visual information, time and ability to pick up incidental findings.
Conclusion: We identified a proof-of-concept solution to objectively and robustly capture skin disease, with an office and home workflow that is acceptable to providers and patients. This fast, scalable method is deployable on smartphones and could be utilized to augment clinical decision making in the clinic and to empower patients at home.
2. Guido N, Hagstrom EL, Ibler E, et al. A novel total body digital photography smartphone application designed to detect and monitor skin lesions: a pilot study. J Surg Dermatol. 2018;3(2). doi:10.18282/jsd.v3.i2.177
3. Ramsay B, Lawrence CM. Measurement of involved surface area in patients with psoriasis. Br J Dermatol. 1991;124(6):565-570. doi:10.1111/j.1365-2133.1991.tb04952.x
4. Nichter LS, Williams J, Bryant CA, Edlich RF. Improving the accuracy of burn-surface estimation. Plast Reconstr Surg. 1985;76(3):428-433.
5. Kohli I, Isedeh P, Al‐Jamal M, et al. Three-dimensional imaging of vitiligo. Exp Dermatol. 2015;24(11):879-880. doi:10.1111/exd.12791
6. Börve A, Dahlén Gyllencreutz J, Terstappen K, et al. Smartphone teledermoscopy referrals: a novel process for improved triage of skin cancer patients. Acta Derm Venereol. 2015;95(2):186-190. doi:10.2340/00015555-1906
7. Deng X, Zhou G, Xiao B, Zhao Z, He Y, Chen C. Effectiveness evaluation of digital virtual simulation application in teaching of gross anatomy. Ann Anat Anat Anz Off Organ Anat Ges. 2018;218:276-282. doi:10.1016/j.aanat.2018.02.014
8. Zilverschoon M, Kotte EMG, van Esch B, Ten Cate O, Custers EJ, Bleys RLAW. Comparing the critical features of e-applications for three-dimensional anatomy education. Ann Anat Anat Anz Off Organ Anat Ges. 2019;222:28-39. doi:10.1016/j.aanat.2018.11.001
9. Swerlick RA, Zhang C, Patel A, Chren MM, Chen S. The Skindex-mini: a streamlined QOL measurement tool suitable for routine use in clinic. J Am Acad Dermatol. December 2018. doi:10.1016/j.jaad.2018.12.035
10. Armstrong A, Puig L, Langley R, et al. Validation of psychometric properties and development of response criteria for the psoriasis symptoms and signs diary (PSSD): results from a phase 3 clinical trial. J Dermatol Treat. 2019;30(1):27-34. doi:10.1080/09546634.2017.1364694
11. Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2019 | CMS. https://www.cms.gov/newsroom/fact-sheets/final-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year. Accessed April 16, 2019.