Noe Megan H, Rodriguez Olaf, Taylor Laura, Sultan Laith, Sehgal Chandra, Schultz Susan, Gelfand Joel M, Judson Marc A, Rosenbach Misha
Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA.
Sarcoidosis Vasc Diffuse Lung Dis. 2017;34(2):136-141. doi: 10.36141/svdld.v34i2.5720. Epub 2017 Aug 25.
As is the case for many skin diseases, cutaneous sarcoidosis does not currently have an objective measure of disease burden to establish disease severity and response to treatment. The disease has traditionally been assessed by visual skin changes, including induration and erythema; however, such assessments may fail to quantify the total skin granuloma burden, as the majority of the granulomatous inflammation may lie deep within the dermis and not be reliably detected by sight or palpation.
The purpose of this pilot study is to evaluate the feasibility of high frequency ultrasound as an objective measure of granuloma burden in cutaneous sarcoidosis and to compare high frequency ultrasound to a previously validated clinical instrument (CSAMI) and histopathology evaluation.
A strong correlation was observed between the mean brightness of high frequency ultrasound images and both the lesional CSAMI score (Spearman's rho: 0.9710, p = 0.0012) and percent of dermis with granulomas histopathology (Spearman's rho: 0.8407 p = 0.0361).
These results confirm high frequency ultrasound is a valid, objective measure of granuloma burden in cutaneous sarcoidosis and represents a novel, non-invasive measure of disease severity that correlates to the previously validated CSAMI clinical severity score and histopathology evaluation.
与许多皮肤病一样，皮肤结节病目前尚无用于确定疾病严重程度和治疗反应的疾病负担客观测量方法。传统上，该疾病是通过皮肤外观变化进行评估的，包括硬结和红斑；然而，此类评估可能无法量化皮肤肉芽肿的总负担，因为大多数肉芽肿性炎症可能位于真皮深层，无法通过视诊或触诊可靠检测到。
本初步研究的目的是评估高频超声作为皮肤结节病肉芽肿负担客观测量方法的可行性，并将高频超声与先前验证的临床仪器（CSAMI）和组织病理学评估进行比较。
高频超声图像的平均亮度与病变CSAMI评分（Spearman相关系数：0.9710，p = 0.0012）和肉芽肿组织病理学占真皮的百分比（Spearman相关系数：0.8407，p = 0.0361）之间均观察到强相关性。
这些结果证实高频超声是皮肤结节病肉芽肿负担的有效、客观测量方法，代表了一种与先前验证的CSAMI临床严重程度评分和组织病理学评估相关的新型非侵入性疾病严重程度测量方法。
