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Differentiation of Inflammatory Papulosquamous Skin Diseases Based on Skin Biophysical and Ultrasonographic Properties: A Decision Tree Model Publisher Pubmed



Yazdanparast T1 ; Yazdani K2 ; Ahmad Nasrollahi S1 ; Nazari M3 ; Darooei R4 ; Firooz A1, 5
Authors
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Authors Affiliations
  1. 1. Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, 415 Taleghani Avenue, Tehran, Iran
  2. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Electrical Engineering Department, Sharif University of Technology, Tehran, Iran
  4. 4. Department of Bioelectronic and Biomedical Engineering, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Clinical Trial Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Indian Journal of Dermatology, Venereology and Leprology Published:2020


Abstract

The biophysical and ultrasonographic properties of the skin change in papulosquamous diseases. Aims: To identify biophysical and ultrasonographic properties for the differentiation of five main groups of papulosquamous skin diseases. Methods: Fifteen biophysical and ultrasonographic parameters were measured by multiprobe adapter system and high-frequency ultrasonography in active lesions and normal control skin in patients with chronic eczema, psoriasis, lichen planus, pityriasis rosea and parapsoriasis/mycosis fungoides. Using histological diagnosis as a gold standard, a decision tree analysis was performed based on the mean percentage changes of these parameters [(lesion-control/control) ×100] for differentiation of the diseases. Results: The accuracy of the decision tree model for differentiation of five diseases was 67% which developed based on changes in stratum corneum hydration, epidermal thickness, skin pH, melanin index, R0 (reciprocal of firmness) and erythema. Among the flowcharts for pairs of diseases, three models for differentiation had high accuracy (> 95%): those of psoriasis from lichen planus, pityriasis rosea, and parapsoriasis/mycosis fungoides. Limitations: Validation studies on a larger sample size in situations where the diagnosis is unclear are needed to confirm the accuracy and applicability of decision trees. Conclusion: Skin biophysical and ultrasonographic properties may help in the differentiation of papulosquamous diseases as simple and non-invasive tools. © 2020 Wolters Kluwer Medknow Publications. All rights reserved.