Testing the Reliability of Optical Coherence Tomography to Measure Epidermal Thickness and Distinguish Volar and Nonvolar Skin

Molly E. Baumann; Nina Rossa Haddad; Alyssa Salazar; W. Lee Childers; Shawn Farrokhi; Neil B. Goldstein; Brad D. Hendershot; Lisa Reider; Richard E. Thompson; Michael S. Valerio; Christopher L. Dearth; Luis A. Garza

JID Innovations (Jul 2024)

Testing the Reliability of Optical Coherence Tomography to Measure Epidermal Thickness and Distinguish Volar and Nonvolar Skin

Molly E. Baumann,
Nina Rossa Haddad,
Alyssa Salazar,
W. Lee Childers,
Shawn Farrokhi,
Neil B. Goldstein,
Brad D. Hendershot,
Lisa Reider,
Richard E. Thompson,
Michael S. Valerio,
Christopher L. Dearth,
Luis A. Garza

Affiliations

Molly E. Baumann: Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA; Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, San Antonio, Texas, USA; Correspondence: Molly E. Baumann, Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, Texas 78234, USA.
Nina Rossa Haddad: Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Alyssa Salazar: Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, San Antonio, Texas, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
W. Lee Childers: Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA; Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, San Antonio, Texas, USA; Department of Physical Medicine & Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Shawn Farrokhi: Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA; Department of Physical Therapy, Chapman University, Irvine, California, USA
Neil B. Goldstein: Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
Brad D. Hendershot: Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA; Department of Physical Medicine & Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
Lisa Reider: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Richard E. Thompson: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Michael S. Valerio: Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Christopher L. Dearth: Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Luis A. Garza: Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Cell Biology, Johns Hopkins School of Medicine, Baltimore, USA; Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, USA

Journal volume & issue: Vol. 4, no. 4
p. 100276

Abstract

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In persons with limb loss, prosthetic devices cause skin breakdown, largely because residual limb skin (nonvolar) is not intended to bear weight such as palmoplantar (volar) skin. Before evaluation of treatment efficacy to improve skin resiliency, efforts are needed to establish normative data and assess outcome metric reliability. The purpose of this study was to use optical coherence tomography to (i) characterize volar and nonvolar skin epidermal thickness and (ii) examine the reliability of optical coherence tomography. Four orientations of optical coherence tomography images were collected on 33 volunteers (6 with limb loss) at 2 time points, and the epidermis was traced to quantify thickness by 3 evaluators. Epidermal thickness was greater (P < .01) for volar skin (palm) (265.1 ± 50.9 μm, n = 33) than for both nonvolar locations: posterior thigh (89.8 ± 18.1 μm, n = 27) or residual limb (93.4 ± 27.4 μm, n = 6). The inter-rater intraclass correlation coefficient was high for volar skin (0.887–0.956) but low for nonvolar skin (thigh: 0.292–0.391, residual limb: 0.211–0.580). Correlation improved when comparing only 2 evaluators who used the same display technique (palm: 0.827–0.940, thigh: 0.633–0.877, residual limb: 0.213–0.952). Despite poor inter-rater agreement for nonvolar skin, perhaps due to challenges in identifying the dermal–epidermal junction, this study helps to support the utility of optical coherence tomography to distinguish volar from nonvolar skin.

Published in JID Innovations

ISSN: 2667-0267 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Dermatology
Website: https://www.journals.elsevier.com/jid-innovations

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