Ultrasound Morphea Activity Scoring (<scp>US‐MAS</scp>): Modified <scp>US‐MAS</scp>

Wortsman, Ximena; Vera‐Kellet, Cristián

doi:10.1002/jum.16247

Cited by 8 publications

(5 citation statements)

References 11 publications

(23 reference statements)

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“…Potential biomarkers studied currently include expression of CXCL9, CXCL10, and chemokines in interferon-regulated pathways . Imaging studies may also provide objective outcome measures, particularly magnetic resonance imaging, ultrasonography, and 3-dimensional stereophotogrammetry . Further work is needed to validate these as markers of disease activity in the clinical and research setting.…”

Section: Discussionmentioning

confidence: 99%

Responsiveness to Change of the Morphea Activity Measure in Pediatric Patients

García-Romero,

Brandling-Bennett,

Pope

et al. 2024

JAMA Dermatol

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ImportanceDetecting activity of morphea can be complex but is crucial for adequate treatment and outcome assessment. The Morphea Activity Measure (MAM) was recently validated, but its responsiveness to change in disease activity has not been studied.ObjectiveTo evaluate the internal and external responsiveness of MAM to changes in disease activity in pediatric patients.Design, Setting, and ParticipantsThis multicenter prospective, longitudinal prognostic study was performed from October 2021 to January 2023 at 4 pediatric referral centers in North America. Consecutive pediatric patients with morphea who were available for data collection at baseline and at a follow-up visit at least 3 months later were studied.ExposurePatient demographics, clinical characteristics, and measurements of disease activity collected at baseline and the subsequent visit.Main Outcome and MeasuresResponsiveness of MAM to disease activity according to the modified Localized Scleroderma Severity Index (mLoSSI), the Physician Global Assessment (PGA), and a patient and parent global assessment (PtGA) was analyzed using mean and percentage change, standardized effect size, and standardized response mean (SRM) from baseline to follow-up 3 or more months later. Differences between patients whose activity improved vs did not improve were evaluated using the Mann-Whitney U test. The correlation between percentage change in MAM score and mLoSSI, the PGA, and the PtGA was calculated using Spearman rank correlation.ResultsA total of 43 patients (mean [SD] age at onset, 7.11 [3.18] years; 26 [60.5%] female) were included. The mean change and percentage change in MAM score were significantly larger in those whose disease activity improved by the PGA (mean: −18.75 [95% CI, −31.92 to −5.57] vs 2.73 [95% CI, −1.97 to 7.45]; percentage: −108.08% [95% CI, −155.21% to −60.95%] vs −24.11% [95% CI, −81.22% to 32.99%]) and by mLoSSI (mean: −24.15 [95% CI, −41.89 to −6.41] vs −1.30 [95% CI, −8.50 to 5.70]; percentage: −172.06% [95% CI, −263.68% to −80.45%] vs −21.57% [95% CI, −48.13% to 4.97%]) than in those whose activity did not change. The SRM of MAM was significantly different between groups for both measures; the responsiveness was large in those whose activity decreased by the PGA (−0.75 [95% CI, −1.29 to −0.22]) and mLoSSI (−0.97 [95% CI, −1.69 to −0.25]) and none to small in those whose activity did not change by the PGA (0.11 [95% CI, −0.08 to 0.30]) or mLoSSI (−0.05 [95% CI, −0.34 to 0.23]). Percentage change in MAM score correlated strongly and significantly with change in mLoSSI (ρ = 0.69; P &lt; .001) and PGA (ρ = 0.65; P &lt; .001), but there was no correlation with change in the PtGA (ρ = 0.26; P = .09).Conclusions and RelevanceIn this prognostic study, MAM was found to be internally and externally responsive to changes in disease activity. Further evaluation in mixed cohorts of all ages and specialties is needed.

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Section: Discussionmentioning

confidence: 99%

Responsiveness to Change of the Morphea Activity Measure in Pediatric Patients

García-Romero,

Brandling-Bennett,

Pope

et al. 2024

JAMA Dermatol

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“…This system was further modified by Wortsman et al , 2023, who proposed further subdividing corporal segments during US examinations for higher sensitivity and standardization. [ 24 ]…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Utility in the Management of Morphea: A Comprehensive Review

Khan,

Khachemoune

2024

Indian Dermatology Online Journal

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Introduction: Morphea, an autoimmune progressive disorder, can significantly impact patient well-being, yet therapeutic options, though expanding, exhibit limited efficacy. A persistent challenge in disease management revolves around monitoring disease activity and gauging treatment effectiveness. To address this, various clinical assessment tools have been devised, each with its inherent limitations. The realm of imaging in morphea has undergone noteworthy expansion, with ultrasonography (US) emerging as an efficacious and cost-effective avenue for quantifying disease activity and evaluating therapeutic outcomes. However, the evidential support for its application remains equivocal. Our aim was to explore and analyze the existing evidence concerning the utility of ultrasound in the management of morphea. Materials and Methods: We conducted a comprehensive literature review using PubMed Medline to assess evidence concerning US utility in morphea management. Results: Sixteen total studies were included in our review. Discussion: Although the studies presented carry their own limitations, cumulative findings indicate the potential of ultrasound, particularly when coupled with Doppler, in facilitating staging, assessing disease activity, and longitudinal assessment of therapeutic efficacy in patients with morphea.

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“…In this study, our group used the ultrasound scoring US-MAS for assessing activity 16 ; however, a new modified US-MAS has been recently reported by Wortsman and Vera-Kellet, which includes an even more detailed ultrasound scanning considering corporal regions and their subregions. 37…”

Section: Discussionmentioning

confidence: 99%

Color Doppler Ultrasound Assessment of Subclinical Activity With Scoring of Morphea

et al. 2023

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Background Detection of activity in morphea is paramount for adequately managing the disease. Subclinical ultrasound involvement on inactive lesions or healthy skin areas adjacent to morphea has not been described to date. Objectives The study aimed to detect morphea’s subclinical activity by Color Doppler ultrasound not identified with the clinical scorings. Materials & methods This cross-sectional retrospective study was done from January 2014 to July 2019 in patients with a clinicopathological diagnosis of morphea. The modified Localized Scleroderma Skin Severity Index (mLoSSI) and The Ultrasound Morphea Activity Score (US-MAS) were used to correlate clinical and subclinical activity. Results A total of 36 patients met the inclusion criteria. 54% of cases presented subclinical activity in areas adjacent to the clinically active lesion, 23% in nonadjacent regions, and 23% demonstrated activity at a clinically inactive lesion site. 100% of patients with morphea “en coup de sabre” involving the frontal region of the face concomitantly presented both subclinical activities of morphea on the frontal facial region and the scalp following the same axis. A positive relationship was observed between the degree of clinical activity measured by mLoSSI and US-MAS scoring. The main limitations of our study were the low number of patients and the inability to detect alterations < 0.1 mm. Conclusions Subclinical activity is frequent in morphea, can extend beyond the lesional areas, including apparently noninvolved adjacent and distant corporal regions, and can be detected by color Doppler ultrasound.

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Ultrasound Morphea Activity Scoring (US‐MAS): Modified US‐MAS

Cited by 8 publications

References 11 publications

Responsiveness to Change of the Morphea Activity Measure in Pediatric Patients

Responsiveness to Change of the Morphea Activity Measure in Pediatric Patients

Ultrasound Utility in the Management of Morphea: A Comprehensive Review

Color Doppler Ultrasound Assessment of Subclinical Activity With Scoring of Morphea

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