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Assessing urticaria pathology from lesion geometry



Photo by: Allergyresearch via Wikimedia Commons

A group of researchers from Japan have developed a mathematical model to infer the pathological state of chronic spontaneous urticaria (CSU) based on the geometry of the patient’s skin eruptions.


The findings were published in Communications Medicine (Dec. 4, 2023; 3(1):171).


In the paper, the authors note that the mechanism underlying the various shapes taken by CSU wheals in vivo is not well understood. They write that it is important to integrate recent findings of the pathophysiological characteristics of urticaria with the in vivo dynamics of the condition, including autoimmune responses, cellular infiltrates, and activation of the coagulation pathway by the complement system.


The researchers used hierarchical mathematical modelling to analyze the shapes of skin eruptions and link these morphological features to the in vivo pathological dynamics of CSU. By incorporating both the intravascular and extravascular dynamics using in vitro experimental data, they classified the skin eruption patterns into five potential types. Using these patterns, the researchers developed the Criteria for Classification of Eruption Geometry (EGe criteria) according to their relations with tissue factor and histamine dynamics of mast cells, which act on blood vessels and induce wheal formation. The researchers then demonstrated the validity of their mathematical model to classify CSU according to these criteria in 105 patients, finding the reliability to be as high as 87.6% when analyzed by dermatologists.


“This study was the first to use mathematical models to clarify the pathophysiology of skin eruptions according to their morphology and can help to pave the way for alternative treatment methods,” said lead author Sungrim Seirin-Lee, PhD, in a press release. “For example, patients might take photos of their skin eruptions to provide data for a definitive diagnosis of underlying causes, or the effectiveness of treatment can be monitored over time. In addition, this study shows the promise of mathematical models in understanding the mechanisms of human-specific diseases, where animal models are not available.”


Through these efforts, the authors hope to pioneer mathematical dermatology as a new multidisciplinary research field for practical use, integrating mathematical science and clinical dermatology to elucidate the pathophysiology of skin diseases and develop new strategies for managing intractable skin diseases.

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