Pilot use of 3-dimensional photography to aid clinical decision-making in craniofacial morphea

Ganske, Ingrid M.; Cappitelli, Alex; Langa, Olivia C.; Min, Michelle; Torok, Kathryn S.; Dedeoğlu, Fatma; Vleugels, Ruth Ann

doi:10.1016/j.jdcr.2022.05.038

Cited by 5 publications

(2 citation statements)

References 6 publications

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“…During the study period, the Localized Scleroderma Cutaneous Assessment Tool (LoSCAT) was not utilized during routine care at our institution, leaving room for inter-observer variability [ 53 ]. Three-dimensional photography has been proposed as an additional tool for monitoring patients with head variants of linear morphea and may provide an additional strategy for objective assessment of disease course [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical and therapeutic course in head variants of linear morphea in adults: a retrospective review

et al. 2022

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Parry Romberg Syndrome (PRS) and en coup de sabre (ECDS) are head variants of linear morphea with functional and structural implications. This study describes the clinical course, autoimmune co-morbidities, complications, and treatment of adults with PRS/ECDS at a tertiary referral center. We retrospectively reviewed the records of all 34 adult patients with PRS/ECDS identified through billing code search and seen by dermatologists at our institution between 2015 and 2021. Eight patients (23.5%) had ECDS, 8 (23.5%) had PRS, and 18 (52.9%) had overlap. Twenty-six patients (76.5%) reported ocular, oral, and/or neurologic symptoms, and 8 (23.5%) had concomitant autoimmune/inflammatory conditions. Sixteen patients (47.1%) had a skin biopsy, and 25 (73.5%) had imaging. Forty-six MRIs were obtained, of which 6 (13.0%) reported intracranial findings and 25 (54.3%) reported disease-related connective tissue damage. Twenty-four patients (70.6%) underwent systemic treatment during their disease course per available clinical records. Seventeen patients (70.8%) had improved or stable disease upon treatment completion, with an average duration of 22.2 months. Ten patients (41.7%) reported recurrence of disease following the treatment course. To address changes to facial contour, 6 patients (17.6%) opted for procedural treatments. One patient (16.7%) experienced morphea reactivation following a filler injection performed off-immunosuppression. Compared to findings in children, our study suggests adults with PRS/ECDS are more likely to have oral and ocular complications but experience less severe neurologic symptoms. While systemic treatments appear beneficial in most adult patients with PRS/ECDS, disease may recur following discontinuation.

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Section: Discussionmentioning

confidence: 99%

Clinical and therapeutic course in head variants of linear morphea in adults: a retrospective review

et al. 2022

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“…4 Three-dimensional (3D) stereophotogrammetry is a noninvasive, radiation-free imaging modality that has emerged as a potential tool for detecting and quantifying asymmetry in CM. 4,5 Although well-known in the plastic surgery community as a validated means by which to evaluate the success of reconstructive procedures in the setting of facial trauma and other craniofacial disorders, the adoption of 3D stereophotogrammetry by the dermatology community has lagged behind. 6 A recent pilot study 4 demonstrated the ability of 3D stereophotogrammetry to detect pathologic asymmetry in patients with CM, including occult asymmetry not appreciable on clinical examination results alone.…”

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confidence: 99%

Use of 3-Dimensional Stereophotogrammetry to Detect Disease Progression in Craniofacial Morphea

Shaw,

Nguyen,

Rajeh

et al. 2023

JAMA Dermatol

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ImportanceObjectively determining disease progression in craniofacial morphea (CM) is challenging, as clinical findings of disease activity are often lacking.ObjectiveTo evaluate the utility of 3-dimensional (3D) stereophotogrammetry in detecting disease progression in CM over time.Design, Setting, and ParticipantsThis prospective cohort study included 27 pediatric and adult patients with CM from 2 hospitals in Boston (Boston Children’s Hospital and Brigham &amp; Women’s Hospital) consecutively enrolled from April 1, 2019, to March 1, 2023. Review of 3D stereophotogrammetry images and data analysis occurred from March 1 to April 1, 2023.Main Outcomes and MeasuresClinical and 3D stereophotogrammetry assessments were performed at 2- to 12-month intervals, depending on the clinical context. The 3D stereophotogrammetry images were then qualitatively rated as demonstrating no progression or definitive progression by an expert (board-certified plastic craniofacial surgeon) and nonexpert (board-certified dermatologist) in 3D stereophotogrammetry. In addition, κ coefficients were calculated for interrater reliability.ResultsOf 27 patients with CM (19 female; median age, 14 [range, 5-40] years) and 3D stereophotogrammetry images obtained from a minimum of 2 time points (median, 4 [range, 2-10] images) spaced a median of 3 (range, 2-12) months apart, 10 experienced progression of their disease based on clinical assessments performed during the study period. In all cases in which clinical progression was favored, blinded qualitative assessment of 3D stereophotogrammetry images also favored progression with substantial interrater reliability (κ = 0.80 [95% CI, 0.61-0.99]). Furthermore, review of 3D stereophotogrammetry detected occult progression of asymmetry not noted on clinical examination in 3 additional patients.Conclusions and RelevanceIn this prospective cohort study, blinded assessment of sequential 3D stereophotogrammetry images in patients with CM not only corroborated clinical assessment of disease progression but also detected occult progression of facial asymmetry not appreciable on clinical examination alone. Therefore, 3D stereophotogrammetry may serve as a useful adjunct to clinical examination of patients with CM over time. Future investigations are warranted to validate 3D stereophotogrammetry as an outcome measure in CM.

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Comparison of 3D facial photographs and clinical documentation in patients with craniofacial morphea

Nguyen,

Cohen,

Shaw

et al. 2024

Skin Health and Disease

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Diagnosis of craniofacial morphea (CM) relies upon clinical examination of progressive craniofacial changes. We assess the utility of 3D stereophotogrammetry in documenting asymmetry of the face compared to clinical notetaking. This retrospective study of 3D images and clinical documentation included 32 patients (mean age 15.7 years) with CM. A panel of specialists identified additional areas of asymmetry (those highlighted in 3D photographs that were not noted in clinical documentation) and categorised them as likely, ambiguously or unlikely related to CM. 28 patients (87.5%) had asymmetries noted on 3D photos that were not documented in clinical notes. In 46.4% of them, additional areas were deemed consistent with CM. In the remaining patients, additional asymmetries were ambiguous (42.9%) or not thought to be related to CM (10.7%). Our results suggest that adjunctive use of 3D stereophotogrammetry enhances the documentation of CM at discrete clinical time points and therefore could be a better comparative reference during later re‐examination.

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Pilot use of 3-dimensional photography to aid clinical decision-making in craniofacial morphea

Cited by 5 publications

References 6 publications

Clinical and therapeutic course in head variants of linear morphea in adults: a retrospective review

Clinical and therapeutic course in head variants of linear morphea in adults: a retrospective review

Use of 3-Dimensional Stereophotogrammetry to Detect Disease Progression in Craniofacial Morphea

Comparison of 3D facial photographs and clinical documentation in patients with craniofacial morphea

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