Measuring Asymmetry in Facial Morphea via 3D Stereophotogrammetry.

BACKGROUND: Objectively determining tissue loss in craniofacial morphea is challenging. 3D-stereophotogrammetry is a non-invasive modality that maybe a useful adjunct.

OBJECTIVE: To prospectively evaluate 3D-stereophotogrammetry in assessment of craniofacial linear morphea.

METHODS: Participants underwent clinical, quality-of-life, and 3D-stereophotogrammetry assessment. Traditional photographs and 3D-stereophotogrammetry images were rated as mild, moderate, or severe by 2 experts and 2 non-experts. Inter-rater and Intra-rater reliability (on delayed re-scoring) were calculated.

RESULTS: Of 23 craniofacial morphea patients, 3D-stereophotogrammetry detected pathologic asymmetry in 20. 6% (n=14). Providers rated patients as more severely affected when using 3D-stereophotogrammetry versus traditional photographs (19% severe on 3D-stereophotogrammetry vs 0% severe on traditional photographs, p=0.004). Qualitative ratings of both traditional and 3D-images showed high inter- and intra-rater reliability between experts and non-experts alike. Physicians' Global Assessment of Damage scores correlated with mouth asymmetry (p=0.0021), cheek asymmetry (p=0.04), and 3D-stereophotogrammetry ratings (median, mild: 27.5 vs moderate: 46.5 vs severe: 64, p=0.0152). Lower face asymmetry correlated with worse quality-of-life scores (p=0.013).

LIMITATIONS: Small size and cross-sectional design.

CONCLUSIONS: 3D-stereophotogrammetry can reliably detect and quantify asymmetry in craniofacial morphea with greater sensitivity than traditional assessment alone. 3D-stereophotogrammetry maybe a useful adjunct to clinical examination.