The aim of this study is to objectively evaluate whether linear scleroderma (LS) follows Blaschko's lines (BL) in Korean patients using digital image processing. Thirty-two patients with LS were examined. According to the patients' clinical photographs, their skin lesions were plotted on the head and body charts. With the aid of graphics software, a digital image was produced that included an overlay of all the individual lesions and was used to compare the graphics with the published BL. To investigate the image similarity between the graphic patterns of the LS and BL, each case was analyzed by means of Hough transformations and Czekanowski's methods. The comparative investigation of the graphic similarity of distributional patterns between the LS and BL showed that Czekanowski's similarity index was 0.947 on average. In conclusion, our objective results suggest that the graphic patterns of the distribution of the LS skin lesions showed a high degree of similarity and in fact were almost identical to that of BL which may be the lines of embryonic development of the skin. This finding may suggest that some developmental factors during the embryological age could constitute the cause of LS.
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