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their availability in the dermatology consultation is not always assured&#46; We present 2 examples of skin hypopigmentation&#44; in which 3 different devices were used with the objective of comparing their effectiveness in demarcating this type of dermatologic lesion&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">First&#44; we used the Wood&#39;s lamp as a control examination &#40;Quirumed 197-B601 Wood Lamp&#41;&#46; Second&#44; we used a pocket torch with an LED emitting UVA light at a wavelength of 365<span class="elsevierStyleHsp" style=""></span>nm &#40;TATTU U1S&#41;&#44; a technique that Bae and Lee<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> called narrow-band Wood&#39;s lamp&#46; The third device used was the blue light emitted by the screen of a smartphone &#40;iPhone 6 plus&#44; 5&#46;5-inch IPS LED screen&#59; maximum brightness&#44; 500<span class="elsevierStyleHsp" style=""></span>cd&#47;m<span class="elsevierStyleSup">2</span> and peak blue-light emission at 448<span class="elsevierStyleHsp" style=""></span>nm&#41;&#46; To select the blue color emitted by the cellphone&#44; following the methodology proposed by Agrawal et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> we downloaded a blue image from the Internet and saved it to the image gallery to reproduce it later &#40;using the spectrometry app&#44; Blue Light Spectrum Analyzer&#59; for our study&#44; the image used presented a blue-light peak at 435<span class="elsevierStyleHsp" style=""></span>nm&#41;&#46; Finally&#44; the screen setup was changed to increase the brightness to the maximum level&#46; In a completely dark room&#44; we choose the full-screen blue image from the gallery and shone the light on the area with the abnormal pigmentation&#46; The distance between the light source and the lesion was 50<span class="elsevierStyleHsp" style=""></span>cm for all devices&#46; To take photographs&#44; we used the cellphone camera of the iPhone 11 Pro&#44; placed beside the light source&#44; perpendicular to the lesion&#44; using an exposure time of 3<span class="elsevierStyleHsp" style=""></span>s and an optical zoom of 1&#215;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Patient 1 is a 40-year-old woman who presented a hypopigmented linear macule on the back of the right foot&#44; with poorly defined edges&#44; which had appeared 9 months earlier following local injections of corticosteroids &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Patient 2 is a 28-year-old woman with progressive macular hypomelanosis that presented poorly defined nondesquamative hypopigmented macules with a tendency to coalesce in the lumbar region and on the abdomen &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">When the 3 techniques were compared&#44; the LED torch emitting light at 365<span class="elsevierStyleHsp" style=""></span>nm showed greater demarcation of the lesions&#44; without the blue tone seen with the other devices&#46; When the blue light from the cellphone was used&#44; a certain improvement was observed in the demarcation of the lesions&#44; but excess brightness made demarcation difficult in both cases &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The use of blue light from mobile devices has been previously reported as an alternative to a Wood&#39;s lamp for the examination of vitiligo&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">2&#44;4</span></a> In recent studies&#44; the effectiveness of 365-nm LED lamps has been compared to that of conventional Wood&#39;s lamps for the study of vitiligo&#44; pityriasis alba&#44; and achromic nevus&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> In our study&#44; we present for the first time a comparative analysis of different alternatives to Wood&#39;s light for the study of the same hypopigmented lesions and find that the 365-nm LED torch provides greater effectiveness in defining the lesions&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Given that the 2 alternatives examined in this study present emission peaks close to those emitted by conventional Wood&#39;s lamps&#44; both are devices that may be of interest for the study of skin hypopigmentation&#46; The 365-nm LED torches represent an effective&#44; reproducible&#44; and economic alternative to Wood&#39;s lamps for the study of skin hypopigmentation&#46; The high availability of smartphones in our consulting rooms makes this second technique a potential alternative to be borne in mind in the future&#46; To make examinations using blue light emitted by the screens of different smartphones reproducible&#44; it will be necessary to establish the wavelength and brightness to be emitted&#46; Joint study by software developers and dermatologists will be essential to designing applications that make it possible to standardize these parameters and facilitate the reproducibility of the technique using blue light emitted by the screens of different smartphones in our consultations&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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                  \t\t\t\t">320&#8211;400<span class="elsevierStyleHsp" style=""></span>nm &#40;peak at 365<span class="elsevierStyleHsp" style=""></span>nm&#41;&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "365-nm narrowband Wood&#39;s lamp for vitiligo and hypopigmentation disorders"
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                      "titulo" => "Using the blue screen of a smartphone as an alternative to Wood&#39;s lamp for examination of vitiligo"
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Case and Research Letter
New Technologies Applied to the Study of Skin Hypopigmentation
Nuevas tecnologías aplicadas al estudio de hipopigmentaciones cutáneas
J. Monte-Serranoa,
Autor para correspondencia
monte.serrano.juan@gmail.com

Corresponding author.
, J. Cruañes-Monferrerb, M. Ramírez-Llucha, M.F. García-Gila
a Servicio de Dermatología y Venerología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
b Servicio de Dermatología y Venereología, Hospital Universitario Reina Sofía, Murcia, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Conventional Wood&#39;s lamps emit light at between 320 and 400<span class="elsevierStyleHsp" style=""></span>nm&#44; with a peak at 365<span class="elsevierStyleHsp" style=""></span>nm&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> When this radiation is projected on hypopigmented skin&#44; the lack of melanin facilitates visualization of the autofluorescence of the dermal collagen&#44; and the lesions take on a bluish-white color&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> Melanin absorbs light at 365<span class="elsevierStyleHsp" style=""></span>nm more intensely&#44; improving the contrast between the hypopigmented lesion and the healthy skin&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1&#44;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Although Wood&#39;s lamps constitute a basic additional examination technique in the study of skin hypopigmentation&#44; their availability in the dermatology consultation is not always assured&#46; We present 2 examples of skin hypopigmentation&#44; in which 3 different devices were used with the objective of comparing their effectiveness in demarcating this type of dermatologic lesion&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">First&#44; we used the Wood&#39;s lamp as a control examination &#40;Quirumed 197-B601 Wood Lamp&#41;&#46; Second&#44; we used a pocket torch with an LED emitting UVA light at a wavelength of 365<span class="elsevierStyleHsp" style=""></span>nm &#40;TATTU U1S&#41;&#44; a technique that Bae and Lee<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> called narrow-band Wood&#39;s lamp&#46; The third device used was the blue light emitted by the screen of a smartphone &#40;iPhone 6 plus&#44; 5&#46;5-inch IPS LED screen&#59; maximum brightness&#44; 500<span class="elsevierStyleHsp" style=""></span>cd&#47;m<span class="elsevierStyleSup">2</span> and peak blue-light emission at 448<span class="elsevierStyleHsp" style=""></span>nm&#41;&#46; To select the blue color emitted by the cellphone&#44; following the methodology proposed by Agrawal et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> we downloaded a blue image from the Internet and saved it to the image gallery to reproduce it later &#40;using the spectrometry app&#44; Blue Light Spectrum Analyzer&#59; for our study&#44; the image used presented a blue-light peak at 435<span class="elsevierStyleHsp" style=""></span>nm&#41;&#46; Finally&#44; the screen setup was changed to increase the brightness to the maximum level&#46; In a completely dark room&#44; we choose the full-screen blue image from the gallery and shone the light on the area with the abnormal pigmentation&#46; The distance between the light source and the lesion was 50<span class="elsevierStyleHsp" style=""></span>cm for all devices&#46; To take photographs&#44; we used the cellphone camera of the iPhone 11 Pro&#44; placed beside the light source&#44; perpendicular to the lesion&#44; using an exposure time of 3<span class="elsevierStyleHsp" style=""></span>s and an optical zoom of 1&#215;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Patient 1 is a 40-year-old woman who presented a hypopigmented linear macule on the back of the right foot&#44; with poorly defined edges&#44; which had appeared 9 months earlier following local injections of corticosteroids &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Patient 2 is a 28-year-old woman with progressive macular hypomelanosis that presented poorly defined nondesquamative hypopigmented macules with a tendency to coalesce in the lumbar region and on the abdomen &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">When the 3 techniques were compared&#44; the LED torch emitting light at 365<span class="elsevierStyleHsp" style=""></span>nm showed greater demarcation of the lesions&#44; without the blue tone seen with the other devices&#46; When the blue light from the cellphone was used&#44; a certain improvement was observed in the demarcation of the lesions&#44; but excess brightness made demarcation difficult in both cases &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The use of blue light from mobile devices has been previously reported as an alternative to a Wood&#39;s lamp for the examination of vitiligo&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">2&#44;4</span></a> In recent studies&#44; the effectiveness of 365-nm LED lamps has been compared to that of conventional Wood&#39;s lamps for the study of vitiligo&#44; pityriasis alba&#44; and achromic nevus&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> In our study&#44; we present for the first time a comparative analysis of different alternatives to Wood&#39;s light for the study of the same hypopigmented lesions and find that the 365-nm LED torch provides greater effectiveness in defining the lesions&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Given that the 2 alternatives examined in this study present emission peaks close to those emitted by conventional Wood&#39;s lamps&#44; both are devices that may be of interest for the study of skin hypopigmentation&#46; The 365-nm LED torches represent an effective&#44; reproducible&#44; and economic alternative to Wood&#39;s lamps for the study of skin hypopigmentation&#46; The high availability of smartphones in our consulting rooms makes this second technique a potential alternative to be borne in mind in the future&#46; To make examinations using blue light emitted by the screens of different smartphones reproducible&#44; it will be necessary to establish the wavelength and brightness to be emitted&#46; Joint study by software developers and dermatologists will be essential to designing applications that make it possible to standardize these parameters and facilitate the reproducibility of the technique using blue light emitted by the screens of different smartphones in our consultations&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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                  \t\t\t\t">365<span class="elsevierStyleHsp" style=""></span>nm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">410&#8211;780<span class="elsevierStyleHsp" style=""></span>nm &#40;peak at 448<span class="elsevierStyleHsp" style=""></span>nm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coloration of lesions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Blue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bluish white&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Blue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Demarcation of lesions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#43;&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#43;&#43;&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Size of device&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Large&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Small&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Medium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Availability in consulting rooms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#43;&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#43;&#43;&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Average price of device&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8364;50&#8211;&#8364;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#8364;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62;&#8364;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reproducibility&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                    0 => array:2 [
                      "titulo" => "365-nm narrowband Wood&#39;s lamp for vitiligo and hypopigmentation disorders"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
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                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Agrawal"
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                      "doi" => "10.1016/j.jaad.2019.04.041"
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                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;L&#46; Klatte"
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                    0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Exploraci&#243;n del vit&#237;ligo bajo pantalla de luz azul de dispositivos m&#243;viles como alternativa a la luz de Wood"
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                        0 => array:2 [
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