A recent study revealed that multispectral imaging could provide promising accuracy when predicting the progression of pediatric morphea.
Morphea, also known as localized scleroderma, is described as “an inflammatory, fibrosing skin disorder that can be progressive and debilitating.” Furthermore, the study points out that “Assessment of disease activity is difficult and distinction between early-inflamed lesions and late sclerotic lesions can lead to either undertreatment and therefore persistent disease, or overtreatment, with side effects from therapy potentially outweighing benefits.”
As such, researchers set out to evaluate the ability of multispectral imaging to predict disease progression defined as new or enlarging lesions within the subsequent three months, in pediatric patients with morphea.
A total of 17 children aged between 6-18 years were involved in the study and recruited between 2016 and 2022. Of these 17 children, 11 had linear morphea and six had plaque morphea. Researchers collected multispectral images from each child using the Antera™ 3D camera, which provides an analysis of the skin by illuminating the surface from different angles and digitally reconstructing the surface in three dimensions. Hemoglobin variation differentials between the affected skin and the matched contralateral unaffected skin were evaluated at each visit in an effort to evaluate disease activity.
“Multispectral imaging has the benefit of specifically examining the hemoglobin concentration in tissue, and when compared to matched contralateral tissue, can indicate local inflammation and therefore activity.”
A clinical assessment was performed using the Localized Scleroderma Assessment Tool (LoSCAT) and the Children’s Dermatology Life Quality Index (CDLQI). A follow up was conducted every three months for repeat imaging and clinical review.
Progression of disease was defined as an increase of at least two points or a relative increase of at least 20% in the LoSCAT activity index, or a new or enlarging lesion at the time of imaging or within the three-month interval.
The study’s results revealed that 10 of the 17 patients were deemed to have progression at one or more of their study visits. Additionally, all 17 subjects had at least one study visit in which their disease was considered stable.
Researchers noted that the average hemoglobin gradient between affected and matched contralateral unaffected skin was four times greater in patients during disease progression compared to that in patients during the times of disease stability.
A cut-off of a 0.18% hemoglobin gradient between affected and matched contralateral unaffected skin was used so that patients could be differentiated into those who subsequently had progression and those who did not. Researchers note, “With only one patient who flared having a gradient below this cut off, and none of the children who did not progress having gradients above this cut off, the sensitivity of multispectral imaging in pediatric morphea is 90% with specificity of 100%.”
The study concluded by stating, “Multispectral imaging is a novel assessment tool with promising accuracy in predicting progression as an adjunct to clinical assessment in pediatric morphea. Further research should examine its performance against thermography.”
