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Assessment of Erythema and Pallor

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Agache’s Measuring the Skin

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Abstract

Healthy skin has a red component which comes from the sub-epidermal vascular plexus visible through the stratum corneum. The deeper vessels are invisible or look bluish if they are voluminous. The purpura is visible only if it is located in the superficial dermis. It is brighter in color because the red blood cells are extravascular. The red component of the skin depends on the sub-epidermal plexus volume, the vasodilatation level, the overlying epidermis thickness and translucency. Thin epidermis above a rich plexus provides the skin colour with an homogeneous pink component, as in the case of new-born babies.

Erythema is defined by the accentuation of the skin red component. Whether macular like in morbilliform or roseoliform rashes, or diffuse like in erythematous patches or scarlatiniform erythemas, the excessive coloring is induced by the vasodilatation of the sub-epidermal plexus, with or without deeper vasodilatation. As far as measurement is concerned, two main types of erythemas are distinguished : those generated by the isolated vasodilatation of the sub-epidermal and perifollicular plexuses, and those which concern all the skin vascular networks, including the subcutaneous plexus.

In the first category, only are helpful the skin color measurement, the absorption of the haemoglobin wavelengths assessment, and capillaroscopy.

In the second category (assessment of superficial and deep vasodilatation) it is possible to use photoplethysmography, laser-doppler, thermal clearance, epicutaneous xenon clearance, skin thermometry (see the dedicated chapters).

Only are described below methods which are valid to measure isolated superficial vasodilatation and accordingly are the only ones that can measure the erythematous component of global vasodilatation. Quantitative capillaroscopy, a most promising one, is detailed in chapter 60-1.

Pierre Agache: deceased

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Authors and Affiliations

  1. Department of Dermatology, University Hospital of Besançon, 3 Boulevard Alexandre Fleming, 25030, BESANCON, France

    Pierre Agache

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  1. Pierre Agache
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Correspondence to Pierre Agache .

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Editors and Affiliations

  1. Medecine Vasculaire Lab. Ingénierie et de Biologie Cutanées, CHU Besancon Service Dermatologie et, Besancon, France

    Philippe Humbert

  2. San Francisco, California, USA

    Howard Maibach

  3. Department of Dermatology, Saint Jacques University Hospital, Besançon, France

    Ferial Fanian

  4. Univ. Besançon Dépt. Dermatologie, Besançon, France

    Pierre Agache

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Agache, P. (2015). Assessment of Erythema and Pallor. In: Humbert, P., Maibach, H., Fanian, F., Agache, P. (eds) Agache’s Measuring the Skin. Springer, Cham. https://doi.org/10.1007/978-3-319-26594-0_89-1

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  • DOI: https://doi.org/10.1007/978-3-319-26594-0_89-1

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  • Online ISBN: 978-3-319-26594-0

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