{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T23:46:40Z","timestamp":1790466400224,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,12,16]],"date-time":"2018-12-16T00:00:00Z","timestamp":1544918400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003141","name":"Consejo Nacional de Ciencia y Tecnolog\u00eda","doi-asserted-by":"publisher","award":["SALUD-2013-1-201590"],"award-info":[{"award-number":["SALUD-2013-1-201590"]}],"id":[{"id":"10.13039\/501100003141","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Healthcare Engineering"],"published-print":{"date-parts":[[2018,12,16]]},"abstract":"<jats:p>Diabetic skin manifestations, previous to ulcers and wounds, are not highly accounted as part of diagnosis even when they represent the first symptom of vascular damage and are present in up to 70% of patients with diabetes mellitus type II. Here, an application for skin macules characterization based on a three-stage segmentation and characterization algorithm used to classify vascular, petechiae, trophic changes, and trauma macules from digital photographs of the lower limbs is presented. First, in order to find the <jats:italic>skin region<\/jats:italic>, a logical multiplication is performed on two skin masks obtained from color space transformations; dynamic thresholds are stabilised to self-adjust to a variety of skin tones. Then, in order to locate the <jats:italic>lesion region<\/jats:italic>, illumination enhancement is performed using a chromatic model color space, followed by a principal component analysis gray-scale transformation. Finally, characteristics of each type of macule are considered and classified; <jats:italic>morphologic properties<\/jats:italic> (area, axes, perimeter, and solidity), <jats:italic>intensity properties<\/jats:italic>, and a set of <jats:italic>shade indices<\/jats:italic> (red, green, blue, and brown) are proposed as a measure to obviate skin color differences among subjects. The values calculated show differences between macules with a statistical significance, which agree with the physician\u2019s diagnosis. Later, macule properties are fed to an artificial neural network classifier, which proved a 97.5% accuracy, to differentiate between them. Characterization is useful in order to track macule changes and development along time, provides meaningful information to provide early treatments, and offers support in the prevention of amputations due to diabetic feet. A graphical user interface was designed to show the properties of the macules; this application could be the background of a future <jats:italic>Diagnosis Assistance Tool<\/jats:italic> for educational (i.e., untrained physicians) and preventive assistance technology purposes.<\/jats:p>","DOI":"10.1155\/2018\/9397105","type":"journal-article","created":{"date-parts":[[2018,12,16]],"date-time":"2018-12-16T18:31:46Z","timestamp":1544985106000},"page":"1-13","source":"Crossref","is-referenced-by-count":6,"title":["An Application for Skin Macules Characterization Based on a 3-Stage Image-Processing Algorithm for Patients with Diabetes"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0522-1155","authenticated-orcid":true,"given":"Cinthya Lourdes","family":"Toledo Peral","sequence":"first","affiliation":[{"name":"Divisi\u00f3n de Investigaci\u00f3n en Ingenier\u00eda M\u00e9dica, Instituto Nacional de Rehabilitaci\u00f3n \u201cLuis Guillermo Ibarra Ibarra\u201d, Calz. M\u00e9xico\u2013Xochimilco No. 289, Col. Arenal de Guadalupe, Tlalpan, C.P. 14389 Ciudad de M\u00e9xico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Jos\u00e9","family":"Ramos Becerril","sequence":"additional","affiliation":[{"name":"Servicio de Rehabilitaci\u00f3n Cardiaca, Instituto Nacional de Rehabilitaci\u00f3n \u201cLuis Guillermo Ibarra Ibarra\u201d, Calz. M\u00e9xico\u2013Xochimilco No. 289, Col. Arenal de Guadalupe, Tlalpan, C.P. 14389 Ciudad de M\u00e9xico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Vega Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Subdirecci\u00f3n de Medicina del Deporte, Instituto Nacional de Rehabilitaci\u00f3n \u201cLuis Guillermo Ibarra Ibarra\u201d, Calz. M\u00e9xico\u2013Xochimilco No. 289, Col. Arenal de Guadalupe, Tlalpan, C.P. 14389 Ciudad de M\u00e9xico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6258-154X","authenticated-orcid":true,"given":"Arturo","family":"Vera Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"LAREMUS, Secci\u00f3n Bioelectr\u00f3nica, Departamento de Ingenier\u00eda El\u00e9ctrica, Centro de Investigaci\u00f3n y Estudios Avanzados del Instituto Polit\u00e9cnico Nacional, Av. Instituto Polit\u00e9cnico Nacional 2508, Col. San Pedro Zacatenco, Gustavo A. Madero, C.P. 07360 Ciudad de M\u00e9xico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Leija Salas","sequence":"additional","affiliation":[{"name":"LAREMUS, Secci\u00f3n Bioelectr\u00f3nica, Departamento de Ingenier\u00eda El\u00e9ctrica, Centro de Investigaci\u00f3n y Estudios Avanzados del Instituto Polit\u00e9cnico Nacional, Av. Instituto Polit\u00e9cnico Nacional 2508, Col. San Pedro Zacatenco, Gustavo A. Madero, C.P. 07360 Ciudad de M\u00e9xico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4047-4257","authenticated-orcid":true,"given":"Josefina","family":"Guti\u00e9rrez Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Divisi\u00f3n de Investigaci\u00f3n en Ingenier\u00eda M\u00e9dica, Instituto Nacional de Rehabilitaci\u00f3n \u201cLuis Guillermo Ibarra Ibarra\u201d, Calz. M\u00e9xico\u2013Xochimilco No. 289, Col. Arenal de Guadalupe, Tlalpan, C.P. 14389 Ciudad de M\u00e9xico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"2","year":"2006"},{"key":"7","first-page":"73","volume-title":"Piel y diabetes","year":"2013"},{"key":"8","year":"2003"},{"key":"9","year":"2002"},{"key":"10","volume-title":"Principles of diagnosis and anatomy","year":"2009"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-011-2372-5"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.5.855"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2006.05.007"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.129115"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1610-0387.2006.06123.x"},{"issue":"1","key":"17","volume":"26","year":"2014","journal-title":"Journal of Ayub Medical College Abbottabad"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0125578"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0076212"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/496202"},{"issue":"s1","key":"23","first-page":"S60","volume":"2014","year":"2014","journal-title":"Investigaci\u00f3n en Discapacidad"},{"key":"25","first-page":"376","volume-title":"Color gamut transform pairs","year":"1982"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.1016\/j.procs.2015.07.362"},{"issue":"2","key":"27","volume":"5","year":"2015","journal-title":"International Journal of Emerging Technology and Advanced Engineering"},{"issue":"4","key":"28","first-page":"30","volume":"3","year":"2012","journal-title":"International Journal of Applied Information Systems"},{"key":"29","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0029740"}],"container-title":["Journal of Healthcare Engineering"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/jhe\/2018\/9397105.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jhe\/2018\/9397105.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jhe\/2018\/9397105.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,12,16]],"date-time":"2018-12-16T18:31:49Z","timestamp":1544985109000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/jhe\/2018\/9397105\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,16]]},"references-count":20,"alternative-id":["9397105","9397105"],"URL":"https:\/\/doi.org\/10.1155\/2018\/9397105","relation":{},"ISSN":["2040-2295","2040-2309"],"issn-type":[{"value":"2040-2295","type":"print"},{"value":"2040-2309","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,16]]}}}