Feasibility study of mobile phone photography as a possible outcome measure of systemic sclerosis-related digital lesions.

Objective: Clinical trials assessing systemic sclerosis (SSc)-related digital ulcers have been hampered by a lack of reliable outcome measures of healing. Our objective was to assess the feasibility of patients collecting high-quality mobile phone images of their digital lesions as a first step in developing a smartphone-based outcome measure.

Methods: Patients with SSc-related digital (finger) lesions photographed one or more lesions each day for 30 days using their smartphone and uploaded the images to a secure Dropbox folder.

Photoacoustic imaging is a novel tool to measure finger artery structure and oxygenation in patients with SSc.

Systemic sclerosis (SSc)-related digital ischaemia is a major cause of morbidity, resulting from a combination of microvascular and digital artery disease. Photoacoustic imaging offers a newly available, non-invasive method of imaging digital artery structure and oxygenation. The aim of this study was to establish whether photoacoustic imaging could detect and measure vasculopathy in digital arteries, including the level of oxygenation, in patients with SSc and healthy controls.

Three-dimensional optoacoustic imaging of nailfold capillaries in systemic sclerosis and its potential for disease differentiation using deep learning.

The autoimmune disease systemic sclerosis (SSc) causes microvascular changes that can be easily observed cutaneously at the finger nailfold. Optoacoustic imaging (OAI), a combination of optical and ultrasound imaging, specifically raster-scanning optoacoustic mesoscopy (RSOM), offers a non-invasive high-resolution 3D visualization of capillaries allowing for a better view of microvascular changes and an extraction of volumetric measures. In this study, nailfold capillaries of patients with SSc and healthy controls are imaged and compared with each other for the first time using OAI.

State-of-the-art technologies provide new insights linking skin and blood vessel abnormalities in SSc-related disorders.

Objective: A key unanswered question in systemic sclerosis (SSc) is how microvascular abnormality and fibrosis inter-relate. Our aim was to use state-of-the-art non-invasive imaging methods to gain new insights into pathophysiology, comparing patients with different subtypes of SSc, including early dcSSc, not only to healthy controls but also to patients with causes of Raynaud's phenomenon not progressing to fibrosis.

Methods: Laser Doppler imaging, nailfold capillaroscopy, spectroscopy, and ultrasound measured (respectively) perfusion, microvascular structure, oxygenation/oxidative stress, and skin thickening in the hands of 265 subjects: 31 patients with primary Raynaud's phenomenon (PRP), 35 with undifferentiated connective tissue disease (UCTD), 93 with limited cutaneous SSc (lcSSc), 46 with diffuse cutaneous SSc (dcSSc, including 27 'early') and 60 healthy controls.

A Multicenter Study of the Validity and Reliability of Responses to Hand Cold Challenge as Measured by Laser Speckle Contrast Imaging and Thermography: Outcome Measures for Systemic Sclerosis-Related Raynaud's Phenomenon.

Objective: Reliable and objective outcome measures to facilitate clinical trials of novel treatments for systemic sclerosis (SSc)-related Raynaud's phenomenon (RP) are badly needed. Laser speckle contrast imaging (LSCI) and thermography are noninvasive measures of perfusion that have shown excellent potential. This multicenter study was undertaken to determine the reliability and validity of a hand cold challenge protocol using LSCI, standard thermography, and low-cost cell phone/mobile phone thermography (henceforth referred to as mobile thermography) in patients with SSc-related RP.

Pilot study assessing pathophysiology and healing of digital ulcers in patients with systemic sclerosis using laser Doppler imaging and thermography.

Objectives: Systemic sclerosis (SSc)-related digital ulcers (DU) cause significant pain and disability and are often a primary endpoint in clinical trials. However, their pathophysiology has been little studied. The objectives of this prospective study were to determine whether laser Doppler imaging (LDI) and thermography can identify ischaemic components in both fingertip and extensor surface DU and assess ulcer healing.

Microvascular Response in Patients with Complex Regional Pain Syndrome as Measured by Laser Doppler Imaging.

Objectives: Our aim was to investigate the hypothesis that microvascular dysfunction occurs in patients with CRPS. Specifically, whether there were functional differences in either deeper cutaneous blood vessels or more superficial nutritive vessels between the affected and unaffected limb in patients with CRPS, and between CRPS patients and healthy control subjects.

Methods: Twenty-two patients with CRPS (five male; mean age 45 years; eight upper limb involvement, 14 lower limb) and 23 healthy control subjects (one male; 43 years) were recruited.

Non-invasive Imaging of Localised Scleroderma for Assessment of Skin Blood Flow and Structure.

Extensive morphoea causes major morbidity, disability and disfigurement; pathophysiology is poorly understood. The aim of this study was to investigate, with non-invasive imaging, the relationship between localised abnormalities of skin structure and perfusion, which characterise morphoea. Thirty-two patients with morphoea underwent imaging at affected and unaffected sites.

A double-blind, randomized, placebo-controlled crossover trial of the α2C-adrenoceptor antagonist ORM-12741 for prevention of cold-induced vasospasm in patients with systemic sclerosis.

Objectives: Our primary purpose was to evaluate the efficacy of the high-potency α2C-adrenoceptor antagonist ORM-12741 in the attenuation of a cold-induced reduction in finger blood flow and temperature in patients with RP secondary to SSc. Secondary objectives were to assess safety and tolerability.

Methods: This was a phase IIa, randomized, double-blind, crossover, single-dose, placebo-controlled, single-centre study.

Noninvasive measurement of skin autofluorescence is increased in patients with systemic sclerosis: an indicator of increased advanced glycation endproducts?

Objective: Skin autofluorescence noninvasively assesses expression of advanced glycation endproducts and therefore potentially the presence of oxidative stress that is implicated in the pathogenesis of systemic sclerosis (SSc). We investigated whether autofluorescence was increased in patients with SSc, primary Raynaud's phenomenon (RP), and morphea as compared to healthy controls.

Methods: Measurements of autofluorescence were made at 5 upper limb sites in 16 healthy controls, 16 patients with diffuse cutaneous SSc (dcSSc), 15 with limited cutaneous SSc (lcSSc), 15 with primary RP, and 13 with morphea.

The influence of measurement location on reliability of quantitative nailfold videocapillaroscopy in patients with SSc.

Objectives: Nailfold videocapillaroscopy is being increasingly used as a marker of SSc-related microvascular disease, including in response to treatment. However, it requires further validation. Our aim was to assess the inter-observer, intra-observer and test-retest variability of semi-automated measurement of capillary features as well as of a manual density measurement.

Preliminary clinical evaluation of semi-automated nailfold capillaroscopy in the assessment of patients with Raynaud's phenomenon.

Objectives:   Nailfold capillaroscopy is well established in screening patients with Raynaud's phenomenon for underlying SSc-spectrum disorders, by identifying abnormal capillaries. Our aim was to compare semi-automatic feature measurement from newly developed software with manual measurements, and determine the degree to which semi-automated data allows disease group classification.

Methods:   Images from 46 healthy controls, 21 patients with PRP and 49 with SSc were preprocessed, and semi-automated measurements of intercapillary distance and capillary width, tortuosity, and derangement were performed.

Nail-fold capillary abnormalities are associated with anti-centromere antibody and severity of digital ischaemia.

Objectives: Advances in nail-fold capillaroscopy allow capillary abnormalities to be quantified. Our aim was to investigate, in patients with SSc, the relationships between the degree of nail-fold capillary abnormality and disease subtypes (lcSSc and dcSSc), duration of RP and the presence of (i) severe digital ischaemia (as defined by previous i.v.

Quantitative nailfold video capillaroscopy in patients with idiopathic inflammatory myopathy.

Objectives: To quantify nailfold capillary density and dimensions in patients with idiopathic inflammatory myopathy (IIM) and compare them with those in healthy controls; to look for associations with microvascular disease in IIM; and to determine whether nailfold capillary density and dimensions change over time.

Methods: Nailfold video microscopy (x300 magnification) was performed on 24 patients with IIM and 35 healthy controls. Capillary density and dimensions (total width and apical width) were quantified.

Reliability of dermoscopy in the assessment of patients with Raynaud's phenomenon.

Objective: Few rheumatologists have access to wide field or video capillaroscopy (abnormal capillaries being highly predictive of CTD), and a key question is whether they should, therefore, purchase a dermatoscope. The aim of this study was to estimate the inter- and intra-observer variability of dermoscopy (magnification 10x) among rheumatologists with little or no experience of the technique. Good reliability is a necessary prerequisite for a test to be a valid clinical or research tool.

Noninvasive imaging techniques in the assessment of scleroderma spectrum disorders.

Objective: Systemic sclerosis (SSc) affects both microvascular structure and function. Laser Doppler imaging (LDI) and thermal imaging can be used to measure cutaneous blood vessel function. Nailfold capillaroscopy (NC) measures capillary morphology.

Qualitative assessment of surface topography of XeCl laser etched Ni-Cr alloy.

Objectives: The aims of this study were to compare the mode of debonding (adhesive or cohesive) of laser-etched Ni-Cr alloy (Wiron 99) to a standard sandblasting technique, and to a combination of sandblasting and laser etching. The etched surfaces were examined using optical and electron microscopy techniques.

Methods: Five groups of randomly allocated Ni-Cr cylinders were prepared: Group I-sandblasted; Groups II-IV-laser etched at three fluences (3.

The effects of XeCl laser etching of Ni-Cr alloy on bond strengths to composite resin: a comparison with sandblasting procedures.

Objectives: The aim of this study was to determine the effect of laser surface treatment of Ni-Cr alloy on the tensile bond strength of a proprietary composite resin (Panavia 21) in comparison with a conventional sandblasting technique.

Methods: Eighty cylinders of Ni-Cr were randomly allocated into the following groups: Group I-sandblasting only; Group II-low laser fluence (3.0 J/cm(2)); Group III-medium laser fluence (4.

Possible therapeutic use of vasodilator iontophoresis.

Background: Investigation into the effects of a novel vasodilator delivery method (for the eventual treatment of scleroderma related digital ulceration) on healthy controls is reported. When Raynaud's phenomenon (episodic cold-induced colour changes of the fingers) occurs in the context of scleroderma, it can be extremely severe, leading to ulceration and sometimes gangrene. The current treatment of choice for scleroderma-related critical digital ischaemia and/or ulceration is intravenous prostanoid therapy, necessitating hospitalisation.