Comparative morpho-functional assessment of skin in eczema and xerosis: the role of non-invasive dermatoscopy and bioengineering methods

Introduction . Dermatoscopy and bioengineering methods are high-value non-invasive diagnostic tools used to differentiate between eczema and xerosis, which often present with similar clinical features. Although both pathologies are characterized by skin dryness, their morphological and functional natures differ significantly.

Aim . To comparatively characterize the dermatoscopic signs and biophysical indicators of eczema and xerosis, to study the morphofunctional features of eczema and skin xerosis and to identify objective criteria for the differential diagnosis of these pathologies based on dermatoscopic signs and biophysical indicators (corneometry, sebometry, pH-metry).

Materials and methods . The study involved 32 patients with eczema and 27 patients with xerosis. The comprehensive diagnostic approach was employed: morphological changes were examined using polarized dermatoscopy, while the functional state of the skin was assessed through pH-metry, corneometry (moisture measurement) and sebometry (lipid level evaluation).

Results and discussion . In dermatoscopy, yellowish scales and an irregular arrangement of dotted vessels were characteristic for eczema, while thin white scales and an avascular background were the main markers for xerosis. Functional analysis revealed significantly lower skin hydration and lipid levels in the xerosis group, as well as changes in skin surface pH values. According to the Youden index, the avascular background, lipid deficiency, and pH-metric data had the highest value in clarifying the diagnosis of xerosis.

Conclusion . Combining dermoscopy with the results of pH-metry, corneometry, and sebumetry allowed for objective assessment of the «acid mantle» and the functional state of the skin, thereby enabling high-precision differentiation between eczema and xerosis.

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