Wearable Sensors Could Revolutionize AD Management

Image Credit: © sitthiphong - stock.adobe.com

Medical devices, particularly wearable biosensors, are increasingly being used for medical applications beyond traditional hospital settings. These devices, which can be embedded in clothing or adhere to the skin, monitor and record physical or biochemical parameters.¹ Researchers behind a recent review wrote that dermatology stands to benefit from these advancements, particularly in managing atopic dermatitis (AD). Currently, assessing AD relies on subjective visual evaluations and patient reports, which can be inconsistent and impractical for tracking daily fluctuations in disease severity.²

The review stated wearable biosensors offer a promising solution by providing continuous, objective measurements of AD severity and treatment response. They could improve the accuracy of disease assessment and support the growing trend of virtual consultations in healthcare.With this in mind, the study aimed is to evaluate the existing evidence on the effectiveness of wearable biosensors for managing AD and determine their potential benefits in clinical practice.³

Results

Out of 57 abstracts reviewed, 39 papers were selected for detailed examination, focusing on advancements in wearable biosensor technology for monitoring AD such as:

Wearable Biosensor Modules

• Wrist Actigraphy: This method uses accelerometers in wrist devices to measure scratching behavior, a primary symptom of AD. Wrist actigraphs can track scratching with good accuracy and correlate well with clinical data. Limitations include distinguishing scratching from other movements.
• Smartwatches: With multiple sensors, smartwatches can monitor scratching behavior with high accuracy and track heart rate and physical activity.They are useful for nocturnal symptom tracking but have limitations such as difficulty detecting scratching on the arm wearing the device and inability to assess skin appearance without user input.

Integrated Fabrics and Textiles

• Clothing: E-textiles embedded with sensors can measure skin properties like temperature, hydration, and blood oxygen levels. Examples include fabric-based temperature sensors and wearable vests that track heart rate and breathing.
• Bandages and Masks: Smart bandages and masks with sensors can monitor wound healing and skin moisture. These tools could be adapted for severe AD management.
• Epidermal Sensors: Patches and adherent sensors can measure skin hydration and barrier function. Some sensors also monitor sweat composition and skin turgor, which are relevant for AD management.

Sensors Inserted into the Skin

• Transdermal Sensors: Microneedles and microfluidic devices sample interstitial fluid for biomarker analysis. These sensors can monitor cytokines and other biomarkers associated with AD, offering a direct and localized measure of inflammation.

Future Developments

• Flexible Electronics: Innovations like nanotechnology and electronic tattoos hold promise for highly flexible and non-invasive skin monitoring. These technologies aim to provide real-time analysis of various skin parameters.

Challenges and Barriers

• Functionality and User-Friendliness: Wearable sensors must balance accuracy, comfort, and durability while managing sweat and skin interactions. Miniaturization and powering such devices also present significant challenges.
• Clinical Validation: Further research is needed to validate sensor data against clinical standards and integrate these technologies into patient care effectively.

Overall, the researchers determined that wearable biosensors have the potential to revolutionize AD management by providing continuous, objective data, though several technological and practical challenges must be addressed for widespread clinical adoption.

Conclusion

The review found that wearable sensors can be crucial for improving patient care, particularly for conditions like AD which requires accurate monitoring of disease flares and treatment responses. While current devices can track pruritus and correlate with disease severity, researchers stated they have limitations such as being usable only at night and not being suitable for all areas affected by AD. Advanced systems under development aim to measure skin barrier function, inflammation, and small molecules, potentially allowing for comprehensive home monitoring. The review found that integrating these systems with artificial intelligence could enable real-time treatment adjustments, significantly enhancing care for patients with skin conditions.

References

1. Ianculescu MA, Alexandru AD, Coardo D, et al. Smart wearable medical devices-the next step in providing affordable support for dermatology practice. Dermatovenerologie-J Romanian Soc Dermat. 2018;63:295-306.
2. Kim DH, Setlur V, Agrawala M. Proceedings of the 2021 CHI conference on human factors in computing systems. 2021.
3. Khan Y, Todorov A, Torah R, et al. Skin sensing and wearable technology as tools to measure atopic dermatitis severity. Skin Health Dis. 2024;e449. https://doi.org/10.1002/ski2.449