Ultrasound as an outcome measure to assess disease activity in disorders of skin thickening: an example of the use of radiologic techniques to assess skin disease

Bendeck, Sandra E.; Jacobe, Heidi

doi:10.1111/j.1529-8019.2007.00116.x

Cited by 45 publications

(32 citation statements)

References 34 publications

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“…Ultrasonography has been previously reported as being useful for monitoring of morphea lesions [24,25,26,27,28]. Unfortunately, its reliability and validity have not been tested so far.…”

Section: Discussionmentioning

confidence: 99%

Topical Imiquimod 5% Cream for Pediatric Plaque Morphea: A Prospective, Multiple-Baseline, Open-Label Pilot Study

Pope

Doria²,

Theriault³

et al. 2011

Dermatology

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Background/Aims: Therapeutic options for the treatment of plaque morphea are limited. We explored the efficacy and safety of imiquimod cream in children with plaque morphea. Methods: Prospective, open-label, double-baseline study, using imiquimod 5% cream topically for 9 months. The primary outcome measure was improvement in the thickening of morphea plaques using a visual analog scale (VAS) and the DIET score (dyspigmentation/induration/erythema/telangiectasia). Secondary outcome measures were clinicoradiographic correlations and frequency of adverse events. Results: Nine patients, 89% females, with a mean age of 11.33 years (SD = 3.52) were enrolled. At 36 weeks, the mean VAS had decreased from 48.08 (SD = 18.85) to 22.7 (SD = 12.9) (p < 0.0001), and the mean DIET score from 4.38 (SD = 1.2) to 3.06 (SD = 1.39) (p = 0.23). There was very good interrater reliability between DIET score assessments (intraclass correlation coefficient, ICC = 0.75) and VAS (ICC = 0.59) and moderate agreement between parent and investigator VAS (ICC = 0.5). Ultrasonographically measured dermis thickness changed from 1.05 (SD = 0.34) to 0.95 (SD = 0.19) (p = 0.001). One patient experienced ulceration that required temporary discontinuation of intervention. Conclusions: This proof of concept study revealed that imiquimod 5% cream is effective in decreasing the thickening of plaque morphea and safe for pediatric use. Further prospective studies are warranted.

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“…Ultrasonography has been previously reported as being useful for monitoring of morphea lesions [24,25,26,27,28]. Unfortunately, its reliability and validity have not been tested so far.…”

Section: Discussionmentioning

confidence: 99%

Topical Imiquimod 5% Cream for Pediatric Plaque Morphea: A Prospective, Multiple-Baseline, Open-Label Pilot Study

Pope

Doria²,

Theriault³

et al. 2011

Dermatology

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“…Ultrason deri ve subkütan doku tabakalarını tanımlamaya yardımcı olmakla beraber sistemik skleroz ve lokalize skleroderma gibi fibrozan hastalıkların araştırmalarında, ve dermis kalınlığı incelemelerinde yüksek sensitiviteye sahip olduğu bilinmektedir (6)(7)(8)(9)(10)(11)(12). Dört bin üç yüz otuz sekiz morfea deri lezyonu ve 130 sağlıklı kontrol hastasını kapsayan retrospektif bir çalışmada lezyonların %73'ünde mevcut tanısal doğruluk oranının 14-15 MHz yüksek rezolüsyonlu USG kullanımı ile %97'ye yükseldiği saptanmıştır (6).…”

Section: Discussionunclassified

Low Frequency Ultrasonography in Plaque-Type Morphea

Balevi¹,

Eren²,

Üstüner³

et al. 2017

tdd

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Amaç: Düşük frekanslı ultrasonografik incelemenin lokalize sklerodermada deri tabakalarını ve dokuların perfüzyon paternlerini belirleyen başarılı bir yardımcı teknik olduğu düşünülmektedir. Histopatolojik olarak morfea tanısı olan olgularda lezyonlu derinin kalınlığı, elastisitesi, ekojenitesi ve vaskülaritesi gibi temel parametrelere bakılarak düşük frekanslı ultrason tekniğinin klinik takipteki rolünün belirlenmesi amaçlanmıştır. Objective: Low frequency ultrasonographic examination is thought to be a successful adjuvant technique for determination of skin layers and tissue perfusion patterns in localized scleroderma. We aimed to identify the role of this technique in the clinical follow-up via investigation of basic parameters such as skin thickness, elasticity, echogenicity and vascularity in patients diagnosed with morphea by histopathology. Methods: Thirty-five plaque lesions of nineteen patients with morphea and symmetric, uninvolved cutaneous areas were compared by ultrasound in terms of mean skin thickness, elasticity index and elasticity ratio. The associations between the skin thickness and thickness score, elasticity score and elasticity index, echogenicity score and vascularity score were investigated in all tissue levels. Results: Of the morphea lesions, while the mean dermal skin thickness and dermal elasticity ratio were decreased compared to normal skin, the dermal vascularity was solely increased with an increase of the tissue thickness. Only the mean skin thickness was found to be significantly lower compared to the normal skin areas in the hypodermis of the morphea plaque lesions. Conclusion: Low frequency ultrasound can be used as an effective, adjuvant technique in the clinical follow-up of morphea plaque lesions in the levels of dermis and hypodermis.

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“…Cechuje się dużą czułością i powtarzalnością, dobrze koreluje z wynikiem badania klinicznego i w przeciwień-stwie do MRI nie wymaga stosowania znieczulenia u dzieci [29]. W diagnostyce twardziny ograniczonej stosuje się głowice o częstotliwości 10-25 MHz [30]. Im większa jest częstotliwość głowicy, tym większa rozdzielczość urządzenia, ale jednocześnie płytsza penetracja fali.…”

Section: Metody Oceny Aktywności Lub Nasilenia Choroby I Uszkodzenia unclassified

“…Moreover, unlike MRI, it does not require sedation in the evaluation of children [29]. Ultrasound heads in the frequency range of 10-25 MHz range [30] are used in the diagnostics of localized scleroderma. The higher the frequency, the higher the resolution of the ultrasonography unit but, at the same time, the smaller the depth of wave penetration.…”

Section: Metody Oceny Aktywności Lub Nasilenia Choroby I Uszkodzenia mentioning

confidence: 99%

Localized scleroderma – classification and tools used for the evaluation of tissue damage and disease activity/severity

Wolska-Gawron¹,

Krasowska²

2017

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Localized scleroderma is a rare autoimmune disorder affecting the dermis, subcutaneous tissue and deeper structures. The course of localized scleroderma includes three stages: early inflammation, progressive sclerosis and atrophy. The active stage of the disease is characterized by erythema ('lilac ring'), skin induration, and appearance of new or expansion of pre-existing skin lesions during the preceding month. The most recent localized scleroderma classification recognizes five types of the disease: localized, generalized, linear, deep and mixed. Various methods have been proposed for the evaluation of disease activity or severity and tissue damage, including ultrasonography, thermography, durometry, computed tomography and magnetic resonance imaging. However, all of them have their limitations, as they only make it possible to assess one component of the disease: activity or severity or tissue damage. The LS Cutaneous Assessment Tool (LoSCAT) questionnaire is a promising method of patient evaluation because of its availability, repeatability of results and sensitivity to changes resulting from treatment. STRESZCZENIETwardzina ograniczona jest rzadką chorobą autoimmunologiczną, która przebiega z zajęciem skóry, tkanki podskórnej i tkanek głębiej położonych. Choroba klinicznie ma trzy fazy: wczesną zapalną, postępującego stwardnienia i zanikową (atroficzną). Wykładnikami aktywnego procesu chorobowego są: rumień (lilac ring), stwardnienie skóry, pojawianie się nowych wykwitów skórnych lub powiększenie wcześniej istniejących zmian w ciągu ostatniego miesiąca. Najnowsza klasyfikacja wyróżnia pięć typów twardziny ograniczonej: ograniczona, uogólniona, linijna, głęboka i mieszana. Zaproponowano wiele metod oceny aktywności lub nasilenia choroby oraz uszkodzenia tkanek, takich jak ultrasonografia, termografia, durometria, tomografia komputerowa czy rezonans magnetyczny. Ograniczenia powyż-szych badań wynikają z możliwości oceny tylko jednego wykładnika -aktywności lub nasilenia choroby albo uszkodzenia tkanek. Przedstawiona metoda ewaluacji pacjentów oparta na zastosowaniu kwestionariusza do oceny aktywności i nasilenia choroby (LoSCAT) jest godna uwagi ze względu na dostępność narzędzia, powtarzalność wyników, a także czułość formularza na zmiany wynikające z zastosowanego leczenia.

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Ultrasound as an outcome measure to assess disease activity in disorders of skin thickening: an example of the use of radiologic techniques to assess skin disease

Cited by 45 publications

References 34 publications

Topical Imiquimod 5% Cream for Pediatric Plaque Morphea: A Prospective, Multiple-Baseline, Open-Label Pilot Study

Topical Imiquimod 5% Cream for Pediatric Plaque Morphea: A Prospective, Multiple-Baseline, Open-Label Pilot Study

Low Frequency Ultrasonography in Plaque-Type Morphea

Localized scleroderma – classification and tools used for the evaluation of tissue damage and disease activity/severity

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