Application Note
Assessing Skin Fibrosis in Lymphedema with SkinFibroMeter
Lymphedema (LE) is a progressive chronic condition which results from abnormal function and circulation of lymphatic fluids affecting millions of people worldwide. The progressive fluid accumulation in LE limb causes pain, heaviness, skin thickening, hyperpigmentation and altered sensation. Untreated patients are in increased risk of limb swelling, inflammation, skin fibrosis and functional limitations. Skin fibrosis is a serious and irreversible outcome of LE and one of the most difficult symptoms to treat. Therefore, accurate early assessment of lymphedema is essential for LE patients and for managing the LE treatment effectively.
There are only handful of feasible scientifically validated methods and instrumentation for assessing lymphedema reliably. One of these methods is skin induration measurement instrument SkinFibroMeter (Delfin Technologies Ltd.). SkinFibroMeter has a 1.3 mm indenter, and it measures the force (N) that tissue resists against the probe. The more indurated the tissue, the bigger the force. Subcutaneous fibrosis is typically situated 2 – 4 mm under the skin surface. Therefore, the probe is designed to detect fibrotic or indurated area through the skin.
In a research conducted by Yu et al. (2020) SkinFibroMeter was used to assess skin stiffness (SF) with patients who had either upper or lower extremity lymphedema. The results showed that SF increased significantly in patients with lymphedema compared with controls. Skin stiffness was also found strongly correlated with LE stage and difference in skin stiffness was detected in all stages of lymphedema. Measurement of SF with SkinFibroMeter showed increase in SF values with increasing severity of lymphedema. Their results show that tissue fibrosis increases throughout the development of the disease.
”SF value is accurate and reliable for the evaluation of skin fibrosis.”
– Yu et al. (2020)
Sun et al. (2017) also had similar results with SkinFibroMeter in their study. Skin stiffness (SF) of patients with unilateral lower leg lymphedema were assessed and compared with healthy controls. The results clearly showed that skin stiffness was significantly greater with LE patients than with healthy controls. Skin stiffness increased through lymphedema Stage 1 to Stage 3, and the mean SF values and mean SF ratios were significantly greater with Stage 3 LE than in patients with either Stage 2 or Stage 1 lymphedema. Also, positive correlation was found between SF and limb circumference ratios in lymphedematous limbs.
”SkinFibroMeter is very sensitive and accurate for detecting skin fibrosis of edematous limbs.”
– Sun et al. (2017)
Sun et al. (2017) added that results of the study clearly show that SkinFibroMeter provides diagnostically valuable information on the severity of skin fibrosis in LE. The quantitative assessment of SF is possible with SkinFibroMeter which can be used in assessment of skin fibrosis but also to monitor the effects of LE treatment.
”The SkinFibroMeter has other advantages; namely, it is highly sensitive, portable, and accurate. Unlike diagnostic methods based on skin biopsy and puncture, SkinFibroMeter measurements are noninvasive and do not damage skin structures, thus reducing patient anxiety.”
– Sun et al. (2017)
Delfin Technologies also has other scientifically proven solutions for lymphedema detection and assessment. LymphScanner, MoistureMeterD Compact and multiprobe MoistureMeterD are used to measure skin tissue water in patients with lymphedema.
Delfin Technologies Ltd
References
Yu, Ziyou et al. 2020. “Assessment of Skin Properties in Chronic Lymphedema: Measurement of Skin Stiffness, Percentage Water Content, and Transepidermal Water Loss.” Lymphatic Research and Biology 18(3): 212–18.
Sun, Di et al. 2017. “The Value of Using a SkinFibroMeter for Diagnosis and Assessment of Secondary Lymphedema and Associated Fibrosis of Lower Limb Skin.” Lymphatic Research and Biology 15(1): 70–76.