Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Longitudinal tracking of skin dynamic stiffness to quantify evolution of sclerosis in chronic graft-versus-host disease

Bone Marrow Transplantation volume 56, pages 989–991 (2021)Cite this article

Subjects

Sclerotic chronic graft-versus-host disease (cGVHD) appears in 20% of cGVHD patients within 3 years of transplant [1]. Skin sclerosis severely impairs quality of life and responds slowly to therapy [1]. The current gold standard for grading cGVHD sclerosis, the NIH skin score, is coarse and subjective [2], motivating calls for more reproducible measures [3].

The Myoton is a handheld device (Fig. S1) that extracts soft tissue biomechanical parameters through a brief mechanical impulse [4]. Previously, we reported that sclerotic cGVHD patients and healthy controls have significant differences in dynamic stiffness measurements [5]. However, whether changes in dynamic stiffness correspond to clinical perception of skin cGVHD response to treatment has not been assessed.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Average dynamic stiffness measurements and linear regression slopes.

References

  1. Inamoto Y, Storer BE, Petersdorf EW, Nelson JL, Lee SJ, Carpenter PA, et al. Incidence risk factors, and outcomes of sclerosis in patients with chronic graft-versus-host disease. Blood 2013;121:5098–103.

    Article  CAS  Google Scholar 

  2. Lee SJ, Wolff D, Kitko C, Koreth J, Inamoto Y, Jagasia M, et al. Measuring therapeutic response in chronic graft-versus-host disease. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: IV. The 2014 Response Criteria Working Group report. Biol Blood Marrow Transpl. 2015;21:984–99.

    Article  Google Scholar 

  3. Cowen EW. Decoding skin involvement in chronic graft-vs-host disease. JAMA Dermatol. 2019;155:777–8.

    Article  Google Scholar 

  4. Vain A. inventor; Myoton AS, assignee. Device and method for real-time measurement of parameters of mechanical stress state and biomechanical properties of soft biological tissue. 2011. US 20130289365 A1.

  5. Chen F, Dellalana LE, Gandelman JS, Vain A, Jagasia MH, Tkaczyk ER. Non-invasive measurement of sclerosis in cutaneous cGVHD patients with the handheld device Myoton: a cross-sectional study. Bone Marrow Transpl. 2019;54:616–9.

    Article  Google Scholar 

  6. Mridha M, Odman S. Characterization of subcutaneous edema by mechanical impedance measurements. J Invest Dermatol. 1985;85:575–8.

    Article  CAS  Google Scholar 

  7. Mitchell SA, Jacobsohn D, Thormann Powers KE, Carpenter PA, Flowers ME, Cowen EW, et al. A multicenter pilot evaluation of the National Institutes of Health chronic graft-versus-host disease (cGVHD) therapeutic response measures: feasibility, interrater reliability, and minimum detectable change. Biol Blood Marrow Transpl. 2011;17:1619–29.

    Article  Google Scholar 

  8. Dellalana LE, Chen F, Vain A, Gandelman JS, Põldemaa M, Chen H, et al. Reproducibility of the durometer and myoton devices for skin stiffness measurement in healthy subjects. Skin Res Technol. 2019;25:289–93.

    Article  Google Scholar 

  9. Chen F, Wang L, Vain A, Ssempijja Y, Dellalana L, Zhang K, et al. Interobserver reproducibility of the Myoton and Durometer devices to measure skin stiffness and hardness in chronic cutaneous graft-versus-host disease patients. Blood. 2019;134:4515.

    Article  Google Scholar 

  10. Palma L, Marques LT, Bujan J, Rodrigues LM. Dietary water affects human skin hydration and biomechanics. Clin Cosmet Investig Dermatol. 2015;8:413–21.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Tsukahara K, Takema Y, Moriwaki S, Fujimura T, Imokawa G. Dermal fluid translocation is an important determinant of the diurnal variation in human skin thickness. Br J Dermatol. 2001;145:590–96.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by Career Development Award Number IK2 CX001785 from the United States Department of Veterans Affairs Clinical Science R&D Service and NIH K12 CA090625. The authors are grateful for the patients and volunteers who participated in this study.

Author information

Authors and Affiliations

  1. Dermatology Service and Research Service, Department of Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA

    Laura X. Baker, Fuyao Chen, Yvette Ssempijja & Eric R. Tkaczyk

  2. Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA

    Laura X. Baker, Fuyao Chen, Yvette Ssempijja & Eric R. Tkaczyk

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

    Fuyao Chen & Eric R. Tkaczyk

  4. Medical Scientist Training Program, Yale School of Medicine, New Haven, CT, USA

    Fuyao Chen

  5. Meharry Medical College, Nashville, TN, USA

    Yvette Ssempijja

  6. Vanderbilt-Ingram Cancer Center, Nashville, TN, USA

    Michael Byrne, Tae Kon Kim & Eric R. Tkaczyk

  7. University of Tartu Institute of Physics, Tartu, Estonia

    Arved Vain

  8. Nashville, TN, USA

    Madan Jagasia

Authors
  1. Laura X. Baker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fuyao Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yvette Ssempijja
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Byrne
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tae Kon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Arved Vain
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Madan Jagasia
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Eric R. Tkaczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

E.T., M.J., and F.C. designed the study. IRB for the study was written by E.T. Chart review was completed by L.B. and confirmed with M.B. and T.K.; A.V. and E.T. developed the Myoton measurement protocol and trained L.B., F.C., and Y.S. to perform Myoton measurements. Subject measurements were performed by L.B. (35 measurement sessions), F.C. (24 sessions), and Y.S. (11 sessions). Analysis including linear regression was conceived by L.B.; L.B. performed the analysis, and Y.S. independently checked the analysis, beginning with raw data from Myoton device. L.B. created all figures and wrote the manuscript drafts, and all co-authors participated in revisions. E.T. was responsible for all aspects of the study.

Corresponding author

Correspondence to Eric R. Tkaczyk.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest. A.V. is the inventor of the Myoton but has no financial interest in the device.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baker, L.X., Chen, F., Ssempijja, Y. et al. Longitudinal tracking of skin dynamic stiffness to quantify evolution of sclerosis in chronic graft-versus-host disease. Bone Marrow Transplant 56, 989–991 (2021). https://doi.org/10.1038/s41409-020-01158-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41409-020-01158-w

This article is cited by

Search

Advanced search

Quick links