Evidencing Vibroacoustic Sensing for Inflammatory Skin Disease Monitoring

Over 300 million people worldwide suffer from Inflammatory Skin Diseases (ISDs) like eczema and psoriasis, experiencing chronic discomfort, pain and psychosocial challenges. Current treatment follows a stepwise approach depending on severity, starting with topical agents, then progressing to phototherapy, conventional systemic drugs, and finally modern, highly targeted (and highly expensive) agents.

Progress up this therapeutic ladder is based on a combination of subjective scores provided by patients, and relatively objective scores from dermatologists. While generally reproducible, skin assessment is notoriously unreliable when assessing features such as erythema in darker skin types. The rate limiting step for patients being treated for ISDs is access to clinicians for assessment of disease response. A lack of objective measures of ISDs means that each stage of treatment requires visual skin assessment, which is time consuming and creates a major bottleneck in care delivery, leading to long wait times (with an average 54-week wait for urgent dermatology in the NHS Lothian alone and 145-week for routine appointments), and increased public healthcare costs (NHS spends £179 million/year for mild-moderate eczema).

Addressing these challenges, our goal is to introduce an objective measurement device to clinical and non-clinical environments where data-driven care can improve patient pathways. From a management perspective, increased understanding of how skin responds to therapy will enable more precise and efficient strategies, reducing time and costs while helping identify which patients are most likely to benefit from specific treatments or interventions.

Thus, the technology that the investigators are seeking to progress is a vibroacoustic sensor which measures the material properties of skin's layers using small vibrations on the surface of the skin. Crucially, our innovation is the ability to measure the elasticity (stiffness) and viscoelasticity (fluid content) of the epidermis, dermis and hypodermis of the skin (its key constituent layers) at high resolution from the surface of the skin (i.e. non-invasively). Our acoustic technology avoids the biases that can be common in optical or visual methods of skin assessment of darker skin as the acoustic properties are pigment independent.

For inflammatory skin disease - and eczema and psoriasis in particular - the investigators want to measure epidermal and dermal changes as indicators of skin condition. Whilst the investigators have an early assessment of an eczema sufferer, they lack sufficient feasibility data that would justify larger scale investment in a clinical trial. Thus, within the current project they plan to test whether there are correlates between expert dermatologist skin assessment and the material metrics from our sensors. A strong correlation would indicate the potential for dermatologist-quality measures to be taken outside of a specialist centre thereby allowing treatment tracking, community treatment assessments and diagnostic confirmations, which would reduce wait times for patients.