title: Dermoscopic insight into skin microcirculation--Burn depth assessment.
abstract: To investigate the effectiveness of dermoscopic observation of skin microcirculation, the dermal capillary integrity of burn wounds was evaluated by dermoscopy according to a proposed algorithm that is designed to distinguish burn wounds between superficial dermal burns: SDB, and deep dermal burns: DDB. As the gold standard for comparison, two widely accepted endpoints of primary healing within 21 days (SDB) or over 21 days after injury (DDB) were used. A number of dermatologists conducted diagnostic imaging by dermoscopy. Comparison among polarized noncontact dermoscopy (PNCD), polarized contact dermoscopy (PCD) and nonpolarized contact dermoscopy (NPD) was also conducted. Images from the three modalities were evaluated for color, pattern and qualitative differences among them. The results of dermoscopy measurements according to the proposed algorithm showed accuracy of 96.7%, sensitivity of 100.0% and specificity of 94.4%. Dermoscopy measurements were significantly more accurate than clinical assessment (p<0.05). The recognition of dots increased for NPD, vessels were most clearly observed under PCD and colours tended to be more distinctly recognized under polarized light. Dermoscopy is a useful and simple tool to evaluate not only epidermal and superficial dermal skin components but also the skin microcirculation.
authors.affiliation: Burns Unit, Nagasaki Hospital, 3-11, Yokogawa-Shinmachi, Nishi-ku, Hiroshima City 733-0013, Japan; Department of Dermatology, Nagasaki Hospital, 3-11, Yokogawa-Shinmachi, Nishi-ku, Hiroshima City 733-0013, Japan. Electronic address: mkyomi@yahoo.co.jp.
authors.forename: Kyomi
authors.initials: K
authors.lastname: Mihara
authors.affiliation: Department of Dermatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajii-Cho, Kamigyo-ku, Kyoto City 602-8566, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nomiyama
authors.affiliation: Department of Dermatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajii-Cho, Kamigyo-ku, Kyoto City 602-8566, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Masuda
authors.affiliation: Burns Unit, Nagasaki Hospital, 3-11, Yokogawa-Shinmachi, Nishi-ku, Hiroshima City 733-0013, Japan; Department of Dermatology, Nagasaki Hospital, 3-11, Yokogawa-Shinmachi, Nishi-ku, Hiroshima City 733-0013, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Shindo
authors.affiliation: Department of Dermatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajii-Cho, Kamigyo-ku, Kyoto City 602-8566, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Yasumi
authors.affiliation: Department of Dermatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajii-Cho, Kamigyo-ku, Kyoto City 602-8566, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sawada
authors.affiliation: Burns Unit, Nagasaki Hospital, 3-11, Yokogawa-Shinmachi, Nishi-ku, Hiroshima City 733-0013, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Nagasaki
authors.affiliation: Department of Dermatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajii-Cho, Kamigyo-ku, Kyoto City 602-8566, Japan.
authors.forename: Norito
authors.initials: N
authors.lastname: Katoh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002056:Burns / Q000175:diagnosis / Q000473:pathology*; D046169:Dermoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008859:Microscopy, Polarization; D008875:Middle Aged; D012867:Skin / Q000098:blood supply / Q000473:pathology*; D015599:Trauma Severity Indices; D055815:Young Adult
keywords: Burn depth assessment; Dermoscopy; Skin microcirculation; Skin ulcer