The following is a summary of “Testing the Reliability of Optical Coherence Tomography to Measure Epidermal Thickness and Distinguish Volar and Nonvolar Skin,” published in the July 2024 issue of Dermatology by Baumann, et al.
In individuals with limb loss, prosthetic devices often cause skin breakdown because the skin on the residual limb (nonvolar) is not designed to bear weight like the skin on the palms and soles (volar skin). Before evaluating treatments to improve skin resilience, it’s essential to establish normative data and assess the reliability of outcome metrics. For a study, researchers sought to utilize optical coherence tomography to characterize the epidermal thickness of volar and nonvolar skin and evaluate the reliability of optical coherence tomography.
Optical coherence tomography images were collected from 33 volunteers (6 with limb loss) at two-time points in four orientations. Three evaluators traced the epidermis to quantify thickness.
Epidermal thickness was significantly greater (P < .01) for volar skin (palm) (265.1 ± 50.9 μm, n = 33) compared to nonvolar locations: posterior thigh (89.8 ± 18.1 μm, n = 27) and 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 two evaluators using the same display technique (palm: 0.827–0.940, thigh: 0.633–0.877, residual limb: 0.213–0.952).
Despite the poor inter-rater agreement for nonvolar skin, likely due to difficulties in identifying the dermal-epidermal junction, the study supported the utility of optical coherence tomography in distinguishing volar from nonvolar skin.
Reference: sciencedirect.com/science/article/pii/S2667026724000237