Researchers have developed and tested a non-invasive, camera-based technique to assess skin changes in patients with scleroderma, potentially replacing the subjective manual examination that has been standard practice for more than 50 years.
Scleroderma (systemic sclerosis) is a rare, chronic autoimmune disease that causes excessive collagen production, leading to hardening and thickening of the skin and internal organs. Physicians currently assess skin involvement by manually pinching the skin, but this approach is subjective and can vary between clinicians, making it difficult to track disease progression or treatment response accurately.
The technique, called spatial frequency domain imaging (SFDI), works by shining patterns of harmless light onto the skin and measuring how the light reflects back. Researchers from Boston University School of Medicine and the Department of Biomedical Engineering studied 49 scleroderma patients and 25 healthy volunteers, imaging six sites across the hands, forearms, and fingers.
Light readings were consistently lower in scleroderma patients compared with healthy individuals. Lower readings correlated with higher clinical skin scores, increased scarring in biopsies and greater skin thickness on ultrasound. Notably, the technique detected differences even in skin that clinicians had scored as normal, suggesting SFDI may identify subtle changes before they become apparent on standard examination.
The findings could address a significant barrier in scleroderma research. Currently, no therapies are specifically approved for skin fibrosis in this condition, partly because imprecise measurement methods can make beneficial treatments appear ineffective in clinical trials.
The researchers suggest this fast, painless, non-contact approach could help clinicians track skin changes more objectively and enable clinical trials to detect treatment benefits more reliably.
Source: Bujor A et al. Spatial frequency domain imaging for assessment of skin fibrosis in systemic sclerosis: a prospective cohort study. The Lancet Rheumatology (2026). DOI: 10.1016/S2665-9913(26)00229-8
