The authors sought to characterise, using non-invasive methods, the biophysical properties of foot skin in healthy and pathological states including xerosis, heel fissures, calluses and corn.
Ninety three volunteers were recruited for the study; all participants presented with one or more of the hyperkeratotic conditions and one or both feet were included for measurements depending on the presentation of the conditions.
The stratum corneum (SC) hydration was measured using a Corneometer CM; ten repeated measures were taken at each skin site and an average value was calculated.
Collagen and elastin fibre organisation (CEFO) was measured using a Reviscometer RVM 600; twenty repeated measures were taken and a mean value calculated.
Skin elasticity in response to suction pressure was quantified using the Cutometer 580 MPA.
Skin surface texture was imaged and analysed using the contrast parameter of the Visioscan VC 98; this measures surface homogeneity with greater values reflecting greater contrast between pixels and therefore rougher skin.
Skin parameters were measured at specific sites: centre and edge of callus and corn, centre of heel fissure and xerotic skin adjacent to the fissure and xerotic plantar heel skin.
Measures were also taken from unaffected or normal skin adjacent to the skin lesions.
Images of the skin lesions were captured using a digital camera.
Previously published criteria were applied to classify the severity of each skin lesion and the differences in the biophysical properties were compared between each classification.
All lesions showed significant differences compared to the normal sites in terms of hydration, elasticity and greater surface texture.
Significant differences were also found in skin properties (except texture) between the different classifications of skin lesion.
Correlation between hydration and elasticity at hyperkeratotic sites was statistically significant in 6 of the 9 tests that were undertaken.
It was determined that sub classification of callus and fissures is possible using hydration and elasticity but not texture data.
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