Ranosz-Janicka Irmina, Lis-Święty Anna, Skrzypek-Salamon Alina, Brzezińska-Wcisło Ligia
Chair and Department of Dermatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
Skin Res Technol. 2019 May;25(3):359-366. doi: 10.1111/srt.12660. Epub 2019 Jan 14.
Clinical characteristics of the lesions are used to identify activity and damage in localized scleroderma (LoS). For high-frequency ultrasound (HF-US), the features of active lesions were described.
Clinical signs of activity and damage in LoS lesions were assessed with the use of Localized Scleroderma Cutaneous Assessment Tool (LoSCAT) and HF-US by two examiners independently. All US images were obtained using a 20 MHz HF-US (DermaLab System, Cortex Technology, Hadsund, Denmark). The dermal thickness (DT) and echogenicity (intensity score, IS) of the LoS lesional dermis were measured in the area of each lesion with the highest score for erythema (ER), skin thickness (ST), and dermal atrophy (DAT). Measurements were compared to the site-matched unaffected skin. The relative difference of DT and IS values was calculated between each lesion and its normal control for comparison among different clinical scores for ER, ST, and DAT.
A total of 92 lesions in 40 adult patients were examined with HF-US. Thirty one lesions were erythematous, 26 were in sclerosis, and 35 were in atrophy. A correlation between the clinical evaluation of the LoS lesions and US measurements was found. The sensitivity and specificity of HF-US were 97% and 90%, respectively. The positive predictive value was 83%, negative predictive value-98%. Interrater reliability was excellent for LoSCAT and HF-US findings.
High-frequency ultrasound allows an accurate assessment of the inflammatory and fibrotic skin lesions in LoS.
皮损的临床特征用于识别局限性硬皮病（LoS）的活动度和损害情况。针对高频超声（HF-US），已对活动性皮损的特征进行了描述。
两名检查者分别使用局限性硬皮病皮肤评估工具（LoSCAT）和HF-US评估LoS皮损的活动度和损害的临床体征。所有超声图像均使用20MHz的HF-US（DermaLab系统，丹麦哈德孙科尔特克斯技术公司）获取。在每个皮损红斑（ER）、皮肤厚度（ST）和真皮萎缩（DAT）评分最高的区域测量LoS皮损真皮的厚度（DT）和回声性（强度评分，IS）。将测量结果与部位匹配的未受累皮肤进行比较。计算每个皮损与其正常对照之间DT和IS值的相对差异，以比较不同临床评分下ER、ST和DAT的情况。
对40例成年患者的92处皮损进行了HF-US检查。31处皮损为红斑性，26处为硬化性，35处为萎缩性。发现LoS皮损的临床评估与超声测量之间存在相关性。HF-US的敏感性和特异性分别为97%和90%。阳性预测值为83%，阴性预测值为98%。LoSCAT和HF-US检查结果的检查者间可靠性极佳。
高频超声可准确评估LoS中的炎症性和纤维化皮肤损害。
