Wireless sensor may help track scleroderma skin changes at home
Five-patient study found measurements rose with standard skin scores
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Scientists at Northwestern University have developed a wireless sensor that may help monitor skin stiffness in conditions such as scleroderma from home.
“The great thing about the sensor is it’s small, the potential for home use is tremendous, and for patients who know that they are at risk and know that they need to be constantly monitoring and detecting, this could give them a really good home-based unit that could potentially communicate data directly to their physician. That’s our goal,” Ann Marie Flores, PhD, an associate professor at Northwestern and a co-corresponding author of the study, said in a university news story.
In a small group of people with scleroderma, the sensor’s measurements generally tracked with scores from the standard clinical method for rating skin thickness. While that method relies on a trained clinician’s judgment, the sensor provides objective measurements and may be easier to use. With further validation, the sensor could have applications for a range of conditions.
The study, “A wearable biomechanical system for medical evaluation of soft tissue disorders,” was published in Science Advances.
Current skin checks rely on expert judgment
People with scleroderma can experience a variety of symptoms, including skin hardening and thickening caused by an excessive buildup of collagen, a major component of scar tissue.
Skin hardening can change over time, so monitoring may help track disease progression. The standard clinical method is the modified Rodnan skin score, or mRSS, sometimes called a pinch test. A trained clinician examines the skin at several body sites and rates its thickness from zero to three.
“This method is subjective, lacks sensitivity to small but clinically meaningful changes, and requires highly experienced, trained evaluators,” the researchers wrote.
As a potential alternative, the team developed a device that attaches to the skin and emits vibrations. It records how the tissue responds and uses those measurements to calculate its elastic modulus, a measure of stiffness.
“The device can wirelessly transmit the data and then we can directly analyze this vibrating amplitude and frequency to know the skin modulus value,” said Min-Seung Jo, PhD, the lead author of the study. A higher modulus value indicates stiffer, less flexible tissue.
Modeling, tests in artificial skin, and measurements in healthy participants showed that the device could reliably measure tissue stiffness in different areas of the body. Its readings also changed with factors that affect tissue stiffness, including muscle contraction.
Based on these findings, the researchers believe that the sensor “can serve as a practical tool capable of supporting early detection of a range of skin and soft tissue pathologies [diseases],” they wrote.
Sensor tested in five people with scleroderma
To demonstrate the sensor’s potential in scleroderma, the researchers tested it in five participants with the condition. Measurements were taken on the index fingers, hands, and forearms on both sides of the body, including affected and unaffected areas.
On average, skin modulus values were more than three times as high in affected areas as in unaffected areas, indicating stiffer, less flexible tissue. At some body sites, values in affected areas were more than 10 times as high.
Skin modulus values also showed a clear increasing trend as mRSS scores increased. The researchers said this suggests “the potential of [the sensor] method as a more objective and sensitive indicator of disease progression.”
The team also tested the device in people with lymphedema, in which lymphatic fluid buildup causes swelling. The sensor measured higher modulus values in affected areas, and the readings generally tracked with established measures of swelling and disease severity.
“Given that both diseases demonstrated here are difficult to fully recover from and require continuous management, there is a growing need to adopt sensing approaches for longitudinal monitoring in patients with chronic conditions during follow-up,” the researchers wrote. Such monitoring could eventually help detect disease progression earlier.
The sensor needs further validation before it can be used in regular clinical practice. It may eventually help physicians diagnose scleroderma and other conditions earlier.
Future work will help determine the sensor’s potential place in clinical practice. “Our next steps are to see how we can make this truly home-based, how adherent patients are … and to hear what providers want to know,” Flores said.
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