The era of ultrasounds in dermatology started in 1979, when pioneering use of 15 MHz by Alexander and Miller in measuring the skin thickness was introduced. Since then, some new applications of high-frequency ultrasonography (HF-USG) have emerged providing the clinicians with an extra hand in their everyday practice. The main advantages of HF-USG include the possibility of real-time imaging, measurements of morphological and physiological aspects of the skin, safety associated with the use of non-ionizing media as well as the lack of contraindications to its performance. Currently the main clinical use of HF-USG in dermatology regards preoperative assessment of the depth of invasion in melanomas and basal cell carcinomas. The ultrasound image analysis allows noninvasive follow-up of inflammatory skin diseases, like atopic dermatitis, psoriasis and may be used for monitoring effectiveness of therapy in skin lymphomas and sclerotic skin diseases.

On the basis of analysis of 16 specimens we can conclude that all pathological changes of AD influence ultrasound image and in addition, the USG picture depends on the phase of disease process.

IntroductionAtopic dermatitis (AD) is a chronic and relapsing skin disorder, which is characterized by abnormal skin barrier function within the entire skin surface. Several noninvasive bioengineering methods have been commonly used to quantify disease severity. High-frequency ultrasonography (HF-USG) is an important contribution to this field.AimTo evaluate noninvolved skin during the external treatment in relation to involved regions in patients with AD skin using noninvasive methods.Material and methodsTransepidermal water loss (TEWL), capacitance and erythema assessment and HF-USG were performed in 55 AD patients within 2 regions (involved and uninvolved skin) before and after therapy. The clinical severity of the disease process was based on the eczema area and severity index (EASI) score. A control group consisting of 15 subjects was also included.ResultsOn the basis of 4 bioengineering methods our study revealed that uninvolved skin in AD presents subclinical disturbances and significantly changes during therapy. The HF-USG detects inflammation in the upper dermis in AD patients in the form of a hypoechoic band, which may also be observed to a lesser extent within normal-appearing skin.ConclusionsNonlesional skin differs significantly from lesional skin in AD and from skin of healthy subjects. Noninvasive methods are able to measure subclinical skin disturbances within normal-appearing skin, which are not evaluated using standard clinical scores. They are objective and may facilitate communication between different research groups.

Our results indicate the significant role of skin ultrasonography in the complete clinical evaluation of patients with AD, which may serve as an element in selection of the most appropriate topical treatment. An echopoor band beneath the echo entry within nonlesional skin of some AD patients may reflect subclinical eczematous reaction and the readiness for the development of typical skin lesions. For this purpose, we suggest to name an intact skin in AD as seemingly healthy skin.

This report shows the usefulness of HF-USG in monitoring tacrolimus therapy in atopic dermatitis. It is worth emphasizing, that this tool is easily reproducible and allows clinicians to visualize pathologic changes of all skin in vivo. As a noninvasive and independent of subjective judgment method, HF-USG should be included in overall evaluation of atopic dermatitis disease severity together with common scores or scales, especially in the era of evidence based medicine.

Introduction One of the most important symptoms of Sjögren syndrome is xerostomia. The oral cavity deprived of saliva and its natural lubricative, protective and antibacterial properties is prone to a number of unfavourable consequences. Aim To present the most important lesions on the oral mucosa in primary and secondary Sjögren syndrome and in dry mouth syndrome. Material and methods The study group comprised 55 patients including 52 women and 3 men aged 20–72 years (average: 28.25 years). Results Basing on the accepted criteria, primary Sjögren syndrome was diagnosed in 22 (40%) patients, secondary Sjögren syndrome in 18 (32.7%) patients, and dry mouth syndrome in 15 (27.27%) patients. The physical examination and the examination of the mouth were performed and history was elicited from every patient. Conclusions The most common pathologies appearing on the oral mucosa in primary and secondary Sjögren syndrome are angular cheilitis, cheilitis, increased lip dryness as well as non-specific ulcerations, aphthae and aphthoid conditions.

A b s t r a c t I In nt tr ro od du uc ct ti io on n: : Atopic dermatitis (AD) is an inflammatory pruritic dermatosis, which is characterized by an impaired skin barrier function manifested as an increased transepidermal water loss (TEWL). A Ai im m: : Presentation results of instrumental evaluation of the skin barrier function in AD patients in relation to the disease severity as well as pruritus. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : Fifty-five AD patients aged from 8 to 60 years were enrolled to the study. Epidermal barrier function (TEWL measurement and corneometry) as well as erythema measurement were determined in each patient within the same affected skin region, antecubital fossa. Clinical evaluation was performed using the W-AZS scoring system. R Re es su ul lt ts s: : There was a statistically significant difference in the mean TEWL values between groups of patients with different degrees of skin inflammation expressed by the W-AZS index, while no significant differences were observed in relation to the skin hydration and ertyhema measurement. There was a statistically significant correlation between the W-AZS index and TEWL as well as between the W-AZS I index and TEWL. C Co on nc cl lu us si io on ns s: : Selected parameters of the skin barrier function (TEWL, skin hydration) and the level of erythema are useful in evaluation of AD. Transepidermal water loss measurement presents a good correlation with W-AZS and with intensity of patients itching. Instrumental assessment provides us with a fast and objective evaluation of the eczema status, what seems to be very important in the era of evidence-based medicine.K Ke ey y w wo or rd ds s: : atopic dermatitis, skin barrier, transepidermal water loss.

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