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. 2023 Oct 1;36(10):524-533.
doi: 10.1097/ASW.0000000000000043.

Using Technology to Detect Erythema Across Skin Tones

Sharon Eve Sonenblum  1 , Rahee Patel, Sarah Phrasavath, Sharon Xu, Barbara M Bates-Jensen
Affiliations

Using Technology to Detect Erythema Across Skin Tones

Sharon Eve Sonenblum et al. Adv Skin Wound Care. .

Abstract

Objective: To examine the effectiveness of the ColorMeter DSM III (ColorMeter; Cortex Technology) at grouping individuals by skin tone and measuring erythema/skin discoloration after erythema induction across skin tones.

Methods: This pre/post experimental study induced erythema on a convenience sample of 61 healthy adults. Skin tone at baseline was measured using the ColorMeter, Munsell Soil Color Chart 5YR (Munsell), and Pantone SkinTone Guide (Pantone) and compared with the Eumelanin Human Skin Colour Scale (Eumelanin Scale) groupings. Erythema and melanin values on the arm immediately and after recovery time were compared with baseline values. Melanin was measured at five body regions on the face and arm.

Results: Participants were predominantly women (64% [n = 39] women, 36% [n = 22] men) and young (mean, 28.8 ± 14.3 years); 5% (n = 3) were Hispanic, 26% (n = 16) Asian, 29% (n = 18) Black, 38% (n = 23) White, and 7% (n = 4) identified with more than one race. ColorMeter lightness (L*) and melanin measures were strongly correlated with both Munsell and Pantone values. Munsell skin tone groups were not aligned with Eumelanin Scale groupings. Most participants were in the Eumelanin intermediate-low group, and this changed depending on which body location melanin value was used. The change in erythema from baseline did not differ significantly across skin tone groups at the ulnar head, but on the forearm at the delayed time point, significant differences existed between light and both medium and dark skin tone groups (P = .001; 95% CI, 0.04-0.37).

Conclusions: The ColorMeter provides an effective objective measure of skin tone and erythema/discoloration across various skin tones and may improve on current standards for detection. The proposed Eumelanin Scale-Modified provides additional sensitivity for persons with medium skin tones.

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Figures

Figure 1.
Figure 1.
COLORMETER MELANIN MEASUREMENT VERSUS MUNSELL VALUE/CHROMA AT THE FOREARM Munsell readings noted as two-digit numbers with one significant figure. The Munsell value was in the ones place, and the chroma was in the tens place (Value.Chroma). Abbreviation: CU, ColorMeter units.
Figure 2.
Figure 2.
PANTONE DARKNESS VALUE VERSUS MELANIN (LEFT) AND L* (RIGHT) OF THE FOREARM AS MEASURED BY THE COLORMETER AND GROUPED ACCORDING TO MUNSELL SKIN TONE GROUPS Pantone darkness value and ColorMeter melanin values increase in the dark skin tone group, whereas L* values decrease. Abbreviation: CU, ColorMeter units.
Figure 3.
Figure 3.
COLORMETER MELANIN VALUE OF THE FOREARM COMPARED WITH THE FOREHEAD ACROSS MUNSELL SKIN TONE GROUPS Melanin value correlations between the arm and forehead are weaker for the Munsell dark skin tone group than the light skin tone group. Abbreviation: CU, ColorMeter units.
Figure 4.
Figure 4.
ERYTHEMA Δ VALUES AT THE ULNAR HEAD These values demonstrated a change in erythema from baseline at both the immediate and delayed time points following erythema induction. Data are grouped by Munsell skin tone grouping.
Figure 5.
Figure 5.
ERYTHEMA Δ VALUES AT THE FOREARM These values demonstrated a change in erythema from baseline at both the immediate and delayed time points following erythema induction. Data are grouped by Munsell skin tone groupings.
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