title: Quantitation of epidermal and mucosal tissue injury using contrast agents and imaging techniques.
abstract: OBJECTIVE
  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.
authors.affiliation: Cincinnati Children's Hospital Medical Center, The Skin Sciences Institute, Cincinnati, OH 45229, USA. marty.visscher@cchmc.org
authors.forename: Marty O
authors.initials: MO
authors.lastname: Visscher
authors.forename: David
authors.initials: D
authors.lastname: Sullivan
authors.forename: Steven
authors.initials: S
authors.lastname: Sullivan
authors.forename: Brian
authors.initials: B
authors.lastname: Barford
authors.forename: Murray
authors.initials: M
authors.lastname: Dock
authors.forename: Marilyn S
authors.initials: MS
authors.lastname: Sommers
mesh_terms: D003287:Contrast Media; D046169:Dermoscopy / Q000379:methods*; D004817:Epidermis / Q000293:injuries* / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008856:Microscopy, Fluorescence / Q000379:methods*; D008875:Middle Aged; D009092:Mucous Membrane / Q000293:injuries* / Q000473:pathology*; D010860:Pigments, Biological / Q000032:analysis*
chemical_list: D003287:Contrast Media; D010860:Pigments, Biological