Measuring asymmetry in facial morphea via 3-dimensional stereophotogrammetry

• Published in: Journal of the American Academy of Dermatology 2023-01, Vol.88 (1), p.101-108
• Main Authors: Abbas, Laila F., Joseph, Adrienne K., Day, Jennifer, Cole, Naomi A., Hallac, Rami, Derderian, Christopher, Jacobe, Heidi T.
• Format: Article
• Language: English
• Subjects: 3D-stereophotogrammetry; craniofacial morphea; Cross-Sectional Studies; Face; Humans; imaging; localized scleroderma; morphea; morphea en coup de sabre; Parry Romberg syndrome; Photogrammetry; Reproducibility of Results; rheumatologic dermatology; Scleroderma, Localized - complications; Scleroderma, Localized - diagnostic imaging
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2022.05.029

Objectively determining tissue loss in craniofacial morphea is challenging. However, 3-dimensional (3D) stereophotogrammetry is a noninvasive modality that may be a useful adjunct. To prospectively evaluate 3D stereophotogrammetry in the assessment of craniofacial linear morphea. Participants underwent clinical, quality-of-life, and 3D-stereophotogrammetry assessments. Traditional photographs and 3D-stereophotogrammetry images were rated as mild, moderate, or severe by 2 experts and 2 nonexperts. In addition, interrater and intrarater reliability (on delayed rescoring) were calculated. Of 23 patients with craniofacial morphea, 3D stereophotogrammetry detected pathologic asymmetry in 14 (20.6%) patients. Providers rated patients as more severely affected when using 3D stereophotogrammetry versus when using traditional photographs (19% severe on 3D stereophotogrammetry vs 0% severe on traditional photographs, P = .004). Qualitative ratings of both traditional and 3D images showed high inter- and intrarater reliability between experts and nonexperts alike. Physicians’ Global Assessment of Damage scores correlated with mouth asymmetry (P = .0021), cheek asymmetry (P = .04), and 3D-stereophotogrammetry ratings (median, mild: 27.5 vs moderate: 46.5 vs severe: 64, P = .0152). Lower face asymmetry correlated with worse quality-of-life scores (P = .013). Small sample size and cross-sectional design. 3D stereophotogrammetry can reliably detect and quantify asymmetry in craniofacial morphea with greater sensitivity than that observed with traditional assessment alone. 3D stereophotogrammetry may be a useful adjunct to clinical examination.