Morphea is an autoimmune disease characterized by skin sclerosis. According to the disease progression, morphea can be divided into inflammatory, sclerotic, and atrophic stages. Dermoscopy and high‐frequency ultrasound (HF‐US) have been applied in the noninvasive evaluation of many inflammatory diseases, but studies on the skin imaging features of the different stages of morphea are limited. To analyze the dermoscopic and HF‐US features of the different stages of morphea and explore their auxiliary value in staging the disease, we followed 34 patients with histopathology‐confirmed morphea between April 2018 and July 2021 who underwent dermoscopy and 50 and 20 MHz HF‐US. Fisher's exact test was used to assess the differences in dermoscopic and HF‐US features among patients with different stages of morphea. Seven patients were classified as the inflammatory stage, 20 as the sclerotic stage, and seven as the atrophic stage by histopathology. The most common dermoscopic features of inflammatory lesions were red structureless areas (100%) and linear curved vessels (85.7%). White clouds and shiny white streaks could be seen in 100% and 90% of sclerotic lesions, respectively. Among atrophic lesions, pigmentary structures (100%) and red structureless areas (85.7%) were the main features. In the HF‐US examination, inflammatory lesions showed hypoechogenicity around the appendages (85.7%), a hypoechogenic dermis (71.4%), and an unclear boundary between the dermis and the subcutaneous fat (71.4%). Among lesions of the sclerotic stage, the main HF‐US characteristics included a hyperechogenic dermis (85.0%), acoustic attenuation of the dermis (70.0%), and an unclear boundary between the dermis and the subcutaneous fat (85.0%). All atrophic lesions showed a hyperechogenic dermis, and 28.6% showed an unclear boundary between the dermis and the subcutaneous fat. Dermoscopy and HF‐US can reveal the characteristic features of the different stages of morphea and show good correspondence with the histopathology. Dermoscopy and HF‐US can provide important information for the staging of morphea.
Background Although the cutaneous involvement of acromegaly has been recognized, the submacroscopical skin changes and the extent of skin thickening of patients remain unclear. Objectives This study aimed at investigating the clinical cutaneous manifestations, dermoscopic features, and skin thickness revealed by high‐frequency ultrasound (HFUS) of acromegalic patients. Methods A case‐control observational study was conducted. Patients with acromegaly and controls were prospectively included and received thorough cutaneous examinations to compare the macroscopical and dermoscopic features. The skin thickness measured by HFUS and its correlation with clinical data were also assessed. Results Thirty‐seven and 26 patients from acromegalic and control group were included, respectively. Clinical skin manifestations were recorded in detail. Under dermoscopy, red structureless area (91.9% vs. 65.4%, p = 0.021), perifollicular orange halo (78.4% vs. 26.9%, p = 0.005), and follicular plug (70.3% vs. 3.9%, p = 0.001) in the facial area, and perifollicular pigmentation (91.9% vs. 23.1%), broom‐head hairs (83.8% vs. 3.9%), honeycomb‐like pigmentation (97.3% vs. 38.46%), widened dermatoglyphics (81.1% vs. 3.9%) at the extremities (p < 0.001) were more prevalent in acromegaly. The mean skin thickness was 4.10 ± 0.48 mm for acromegaly, and 3.55 ± 0.52 mm for controls (p < 0.001) but no correlation with disease duration, adenoma size, and hormone level was found in acromegaly. Conclusions Submacroscopical skin changes under dermoscopy and skin thickness increase assessed by HFUS can provide clinicians with subtle evidences for early detection of acromegaly and objective parameters for accurate assessment of its skin involvement.
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