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To improve diagnostic procedures and facilitate clinical decision-making, computer-assisted image analysis was performed on color slides from 30 patients with histopathologically verified oral lichenoid reactions. Areas from white hyperkeratotic and adjacent red inflamed areas of the lesions were selected and subjected to image analysis. The digitization of the color slides was done by means of an image scanner, and the digital information was transmitted to a personal computer for subsequent feature extraction and analysis. The different oral lesions were characterized as the difference in mean values between white hyperkeratotic and red inflamed areas, respectively, compared with clinically normal tissue. Statistical analyses were made on three different color systems: Red-Green-Blue (RGB), normalized red-green-blue (rgb), and Intensity-Hue-Saturation (IHS). The results showed statistically significant differences in all color systems for both the hyperkeratotic areas and adjacent inflammatory reactions. A linear correlation was obtained when the results of the image analysis of color variations were compared with a clinical score system for hyperkeratosis and inflammation evaluated by two investigators independently.
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