Novel Three-Dimensional Imaging Platform for Digital Facial Vitiligo Area Assessment

BackgroundVitiligo is a chronic autoinflammatory disorder of the skin due to autoimmune-induced loss of melanocytes in the epidermis that leads to skin depigmentation. Currently, there is no reliable, objective measurement of the depigmented vitiligo area in a clinical trial setting. To assess the extent of facial skin depigmentation in vitiligo patients, subjective scoring methods, e.g., the Facial Vitiligo Area Scoring Index (F-VASI), are used in clinical trials; however, these assessments have low sensitivity and high variability. Here, we developed the novel digital 3D imaging platform for vitiligo lesion quantification and objectively assess facial vitiligo changes. MethodsThe 3D imaging platform includes a customized computer visualization app with the handheld stereo optical scanning station. A 3D skin morphology-based image computation model is developed to quantitatively measure facial vitiligo area. To analytically validate this platform, we conducted a synthetic 3D imaging study and a clinical validation study in non-segmental vitiligo patients. In these studies, the 3D imaging platform was used to objectively measure the extent of both synthetic images and facial vitiligo lesions in clinic, and the accuracy and reliability were evaluated. ResultsIn the synthetic image validation study, 6 synthetic skin models were produced with 4 different synthetic size vitiligo regions and 3 different shades, the average area error is <0.05 cm2 for the 6 skin models and <0.04 cm2 for the 4 different circles. In the clinical validation study, 25 participants with at least 3 different skin tones (Fitzpatrick scale II-IV) were enrolled. There was high reliability among different scanners and raters, where all intraclass correlation coefficients for intra-scanner reliability, inter-scanner reliability, intra-rater reliability, and inter-rater reliability were > 0.9. ConclusionsThis study presented a novel digital 3D imaging platform for facial vitiligo area assessment. The clinical study showed high reliability in the use of non-segmental vitiligo patients. The 3D imaging platform demonstrated high sensitivity in detecting changes in facial vitiligo area over time. The 3D imaging technology can be further developed in interventional clinical trials as an objective and sensitive endpoint to detect changes in facial vitiligo with treatment.