Department of Dermatology, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy.
Department of Pathology, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy.
Clin Exp Dermatol. 2019 Apr;44(3):270-276. doi: 10.1111/ced.13693. Epub 2018 Jul 4.
There are few studies in the literature correlating the ultrasonographic findings, clinical scoring systems or histological findings in morphoea after ultraviolet (UV)A1 phototherapy.
To evaluate the quantitative and morphological aspects of high-frequency ultrasonography in the treatment of plaque morphoea in response to UVA1 phototherapy, and to correlate these with clinical and histological scores.
In total, 17 patients with morphoea were studied. Initially and at study end, high-frequency ultrasonography (50 MHz) was performed on the edge of a morphoea lesion treated with UVA1 phototherapy. A quantitative and qualitative analysis of dermal features was performed and compared with the features of healthy skin. Skin biopsy specimens were obtained from lesions analysed at the beginning and end of the study, assessing dermal sclerosis and dermal inflammatory infiltrate and their distribution.
All affected skin showed a statistically significant increase in dermal thickness and hypoechogenicity, corresponding to a reduction in dermal density by ultrasonography compared with healthy skin. Morphological evaluation identified undulations of the dermis in 11 of 17 lesions (64.7%) and in 5 healthy skin areas (29.4%) (P = 0.08), while 'yoyo' figures were identified in 8 lesions (47%) but only 1 healthy skin area (5.9%) (P = 0.02). Ultrasonographic morphological analysis highlighted an improvement in dermal hyperechogenic bands and disappearance of yoyo figures after UVA1 treatment. Histology revealed a reduction in dermal sclerosis and inflammation, although this was not statistically significant.
Ultrasonographic pattern analysis of morphoea is a suitable technique for monitoring UVA1 phototherapy response.
关于紫外线 A1 光疗后硬斑病的超声表现、临床评分系统或组织学发现与哪些因素相关，目前文献中鲜有研究报道。
评估高频超声在 UVA1 光疗治疗斑块状硬斑病中的定量和形态学方面，并将其与临床和组织学评分相关联。
共纳入 17 例硬斑病患者。在初始阶段和研究结束时，使用高频超声（50MHz）对接受 UVA1 光疗的硬斑病病变边缘进行检查。对真皮特征进行定量和定性分析，并与健康皮肤的特征进行比较。从研究开始和结束时分析的病变中获取皮肤活检标本，评估真皮硬化和真皮炎症浸润及其分布。
所有受影响的皮肤均表现出真皮厚度和低回声的统计学显著增加，与超声检查相比，真皮密度降低。形态学评估发现，17 个病变中有 11 个（64.7%）和 5 个健康皮肤区域（29.4%）存在真皮波浪状（P=0.08），而“溜溜球”样表现见于 8 个病变（47%）和 1 个健康皮肤区域（5.9%）（P=0.02）。UVA1 治疗后，超声形态学分析显示真皮高回声带改善，“溜溜球”样表现消失。组织学显示真皮硬化和炎症减少，但无统计学意义。
硬斑病的超声模式分析是监测 UVA1 光疗反应的一种合适技术。
