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Overcoming human disagreement assessing erythematous lesion severity on 3D photos of chronic graft-versus-host disease

Bone Marrow Transplantation volume 53, pages 1356–1358 (2018)Cite this article

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Accurate estimation of extent and severity of erythema is essential for assessing disease severity and treatment response in many diseases, with particular impact on patients with chronic-graft-versus host disease (cGVHD). In cGVHD, reversal of erythema is associated with improved survival [1]. Estimation of erythema surface area and conversion to a NIH 2014 skin score is the current standard of care in cGVHD [2]. However, trained clinicians can detect only a minimum change of 19 to 22% body surface area, [3] an obstacle in proving treatment efficacy necessary for the approval of novel therapeutic agents in clinical trials and daily clinical care of patients with cGVHD [4].

Erythema has been successfully assessed using 2D photography in the case of psoriasis [5]. However, a key difference between psoriasis and cutaneous cGVHD is that the erythema of psoriasis is well defined. Kohli et al. [6] demonstrated 3D-photography as a reproducible method to measure vitiligo. 3D photography has the strength that 3D images can more accurately measure body surface area as 2D images may underestimate involvement of skin areas that fall beyond a contour in the image [6, 7]. In this report, we explore 3D-photography to monitor cGVHD erythema.

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Acknowledgements

Dr. Tkaczyk is grateful for support from NIH K12 CA090625. The authors thank Canfield Scientific for technical support.

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Authors and Affiliations

  1. Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA

    Eric R. Tkaczyk, Fuyao Chen, Inga Saknite & Laura E. Dellalana

  2. Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA

    Eric R. Tkaczyk, Fuyao Chen & Benoit M. Dawant

  3. Department of Veterans Affairs, Tennessee Valley Healthcare System, Dermatology Service, Nashville, TN, USA

    Eric R. Tkaczyk

  4. Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA

    Jianing Wang & Benoit M. Dawant

  5. Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, TN, USA

    Jocelyn S. Gandelman & Madan H. Jagasia

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  1. Eric R. Tkaczyk
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Correspondence to Eric R. Tkaczyk.

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Tkaczyk, E.R., Chen, F., Wang, J. et al. Overcoming human disagreement assessing erythematous lesion severity on 3D photos of chronic graft-versus-host disease. Bone Marrow Transplant 53, 1356–1358 (2018). https://doi.org/10.1038/s41409-018-0211-8

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