Skin ultrasonography and magnetic resonance; new clinical applications and instrumentation

BackgroundTo date, there are no accepted outcome measures to monitor morphea, and consensus on specific monitoring criteria for morphea remains elusive.A few studies have assessed the criterion validity of skin ultrasound in morphea. So, in this study, we approach ultrasound findings in morphea lesions.Material and methodsThis was a retrospective‐analytical study conducted between December 2021 and May 2023. Patients were clinically evaluated at a dermatology outpatient clinic and then referred for high‐frequency ultrasound (HF‐US) evaluation and were selected to be included in this study. The lesions were confirmed by histopathology as well. Sonographic evaluations were performed on the lesion site and the symmetrical uninvolved other side. Dermal thickness and dermal echogenicities were recorded. Statistical analysis of group differences was performed by using the 2‐tailed Student t‐test. A p‐value of less than 0.05 was considered statistically significant.ResultsForty‐one morphea lesions in the inflammatory phase of 27 patients were included in the study. The mean dermal thickness of morphea lesions was 1107.97 ± 414.3 and the mean dermal thickness of the control side was 1094.65 ± 331.06, The difference between these two variables was not statistically significant. The mean dermal density of lesions was 49.13 ± 18.97 and the mean dermal density of the control side was 52.22 ± 25.33. The difference between these two variables was not statistically significant.ConclusionThis study shows that HF‐US indicated increasing dermal thickness and reducing the dermal density of the morphea lesions in the inflammatory phase confirmed with the histopathology.

Section: Discussionmentioning

confidence: 99%

High‐frequency ultrasound evaluation of morphea: Retrospective analytical study

Yazdanparast,

Mohseni,

Dehghan

et al. 2024

“…High‐frequency ultrasound has been used since the late 1990s to visualize underlying skin structures, and recent technological advancements have contributed to a growing list of clinical applications. 30 For example, ultrasound has been used to measure skin thickness and visualize HA fillers in vivo. 23 Several studies have also characterized soft tissue fillers by their physicochemical properties.…”

Section: Discussionmentioning

confidence: 99%

Intracorporeal evaluation of hyaluronic acid fillers with varied rheological properties and correlations with aesthetic outcomes

Nikolis,

Enright,

Cotofana

et al. 2024

BackgroundUnderstanding the differences in soft tissue filler rheology and how these properties can impact clinical results is a fundamental concepts for any injector. This study aimed to assess the tissue integration characteristics of hyaluronic acid (HA) fillers manufactured with different technologies (Non‐Animal Stabilized HA [HA‐N] or Optimal Balance Technology [HA‐O]) using ultra‐high‐frequency ultrasound.MethodsTwelve female participants with mild‐to‐moderate midface volume loss and temporal hollowing were enrolled and treated with HA‐N and/or HA‐O. Participants were seen at five visits (screening/baseline [treatment], and Weeks 1 [optional touch‐up], 4, 6, and 8 [follow‐up visits]). Ultrasound was used to evaluate the degree of product integration.ResultsOn ultrasound, HA‐N presented with distinct borders, minimal tissue integration, and a capacity to displace tissues. Conversely, HA‐O tended to spread horizontally within the same tissue plane and integrated within tissues. The volumizing capacity of the HA‐O fillers was dependent on particle size.ConclusionHA‐N is suited for deep injections in areas such as the upper lateral cheek and under the muscle of the temporal region when a lifting effect is desired; HA‐O is best suited for subcutaneous injections, in areas of dynamic movement or for patients with thin skin; and can be injected subcutaneously or supraperiosteally when a volumizing effect is desired.

“… 6 Zemtsov et al. 7 described skin imaging, the instruments used, the latest advances in diagnostic applications of ultrasound and magnetic resonance imaging (MRI), and the contributions of different specialists to skin imaging. Both high‐frequency ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of type A botulinum toxin treatment for androgenetic alopecia using ultrasound combined with trichoscopy

Li,

Ma,

Luo

et al. 2024

ObjectiveThis study aimed to assess the efficacy of type A botulinum toxin treatment for androgenetic alopecia (AGA) using a combination of ultrasound and trichoscopy.MethodsNinety patients with AGA who visited the Department of Dermatology at the Second Affiliated Hospital of Soochow University from September 2021 to December 2022 were prospectively selected. These patients met the diagnostic criteria outlined in the Chinese Guidelines for the Diagnosis and Treatment of Androgenetic Alopecia. The alopecia severity in the male patients ranged between grades 2 and 4 on the Norwood‐Hamilton Scale. The patients were randomly assigned to receive injections of the same type of biological agent in a double‐blind manner, with injection sites being the vertex or bilateral temporal–frontal hairline. In this study, the botulinum toxin group comprised 72 patients who received a biological agent with 100 units of type A botulinum toxin. The control group included 18 patients, and the biological agent administered to them contained 0 units of type A botulinum toxin. The patients were observed using 22‐MHz ultrasound and trichoscopy before treatment, and 1 month and 3 months after treatment to compare the differences in various parameters at the injection sites. The ultrasound parameters included average follicle width, length, and count. The trichoscopy parameters were the number of hairs within a 1‐cm2 area on the counting scale. No artificial interventions were performed at the injection sites, and all examination conditions were consistent.ResultsThe patients in the botulinum toxin group had wider and longer average follicle width and length at the vertex 1 month and 3 months after treatment (p < 0.05), and wider and longer average follicle width and length in the left frontal area 3 months after treatment (p < 0.05) compared with those in the control group. The average follicle width and length gradually increased after treatment in the botulinum toxin group (p < 0.05), but no statistically significant differences were found in the control group (p > 0.05). The patients in the botulinum toxin group exhibited greater average follicle lengths after treatment at the vertex compared with the left frontal area (p < 0.05). No statistically significant differences were found in follicle count (p > 0.05) or hair count (p > 0.05) between the botulinum toxin and control groups after injection treatment.ConclusionsThe follicle width and length are effective parameters for evaluating the efficacy of type A botulinum toxin treatment for AGA. Ultrasound revealed that the changes in follicles at the vertex occurred earlier than those in the left frontal area following treatment. Additionally, the changes in follicles were detected earlier than the changes in hair count using ultrasound. Ultrasound combined with trichoscopy provided more parameters for evaluating the efficacy of type A botulinum toxin treatment for AGA, resulting in a more comprehensive evaluation.