Introduction Keloids are a prevalent chronic skin disorder with significant psychosocial morbidity. Intralesional corticosteroid injections are the first-line treatment but are painful and require repeated injections by medical professionals. Dissolving microneedles are a novel method of cutaneous drug delivery that induces minimal/no pain and can be self-administered. The objective of the study was to evaluate the efficacy and safety of triamcinolone-embedded dissolving microneedles in treatment of keloids. Methods This was a single-blind, intra-individual controlled two-phase clinical trial of 8-week duration each. Two keloids per subject were selected for (1) once-daily 2-min application with microneedles for 4 weeks, followed by no treatment for the next 4 weeks, or (2) non-intervention as control. Primary outcome was change in keloid volume as assessed by a high-resolution 3D scanner. Results There was significant reduction in keloid volume compared with controls after 4 weeks of treatment. This reduction was greater with a higher dosage of triamcinolone used. Conclusions Once-daily application of dissolving triamcinolone-embedded microneedles significantly reduced the volume of keloids. The treatment was safe, can be self-administered and can serve as an alternative for patients unsuitable for conventional treatments. Trial Registration Trial Registry: Health Science Authority (Singapore) Clinical Trials Register Registration number: 2015/00440.
The in vivo assessment and visualization of skin structures can be performed through the use of high resolution optical coherence tomography imaging, also known as HD-OCT. However, the manual assessment of such images can be exhaustive and time consuming. In this paper, we present an analysis system to automatically identify and quantify the skin characteristics such as the topography of the surface of the skin and thickness of the epidermis in HD-OCT images. Comparison of this system with manual clinical measurements demonstrated its potential for automatic objective skin analysis and diseases diagnosis. To our knowledge, this is the first report of an automated system to process and analyse HD-OCT skin images.
Research letterDrug-free microneedles in the treatment of keloids: a single-blinded intraindividual controlled clinical trial Mean AE SD 218 AE 330 196 AE 293 213 AE 317 À22Á5 AE 49Á2 1 7 Á0 AE 38Á8 À5Á6 AE 22Á9 Median (range) 117 (10Á3-1592) 132 (5Á2-1423) 115 (10Á7-1550) À9Á7 (À169 to 83Á3) 7Á0 (À94 to 127) À1Á7 (À66Á3 to 34Á7) P-value within microneedle group 0Á001 0Á014 0Á41 P-value vs. control group < 0Á001 0Á024 0Á007The size of keloids was based on the mean of three measurements per keloid.
The choroid is the vascular layer of the eye that supplies photoreceptors with oxygen. Changes in the choroid are associated with many pathologies including myopia where the choroid progressively thins due to axial elongation. To quantize these changes, there is a need to automatically and accurately segment the choroidal layer from optical coherence tomography (OCT) images. In this paper, we propose a multi-task learning approach to segment the choroid from three-dimensional OCT images. Our proposed architecture aggregates the spatial context from adjacent cross-sectional slices to reconstruct the central slice. Spatial context learned by this reconstruction mechanism is then fused with a U-Net based architecture for segmentation. The proposed approach was evaluated on volumetric OCT scans of 166 myopic eyes acquired with a commercial OCT system, and achieved a cross-validation Intersection over Union (IoU) score of 94.69% which significantly outperformed (p<0.001) the other state-of-the-art methods on the same data set. Choroidal thickness maps generated by our approach also achieved a better structural similarity index (SSIM) of 72.11% with respect to the groundtruth. In particular, our approach performs well for highly challenging eyes with thinner choroids. Compared to other methods, our proposed approach also requires lesser processing time and has lower computational requirements. The results suggest that our proposed approach could potentially be used as a fast and reliable method for automated choroidal segmentation.
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