Department of Dermatology, University of Pisa, Pisa, Italy.
Department of Pediatrics, Meyer Childern's University Hospital, Florence, Italy.
Exp Dermatol. 2022 Dec;31(12):1863-1871. doi: 10.1111/exd.14664. Epub 2022 Aug 26.
Traditional high-frequency ultrasound (HFUS; 20 MHz) is a non-invasive method used to study skin in vivo but is not able to measure skin thickness accurately and to identify the dermal-epidermal junction (DEJ). Ultra-high frequency ultrasound (UHFUS; 70-100 MHz) has sub-millimetre resolution comparable to histology. The aim of this study was to identify, by UHFUS, the DEJ and to describe skin differences in healthy individuals by providing a measure of skin thickness, based on age and gender. We also described the bullous pemphigoid lesion. We enrolled 42 patients divided into 2 groups: A and B. Group A included 32 healthy volunteers aged 22-74 years. Group B consisted of 10 patients with bullous pemphigoid. For each patient in group A, 8 ultrasound (US) clips by 70 MHz probe were performed at forehead, cheek, nose, forearm, abdomen, chest, back and leg. For each patient in group B, 5 US images were acquired at blisters roofs and edges. In each US image, we measured thickness of stratum corneum (α-β), epidermis (α-γ) and epidermis plus dermis (α-δ). In both groups, we found the presence of 4 lines delimiting: the stratum corneum (the layer between α-line and β-line), the epidermis (distance between α- and γ-line), and the boundary between dermis and subcutis (δ-line). The γ-line corresponds to the point of detachment of the bullae. The abdominal α-β layer was thicker in males (p = 0.019) and α-δ thickness at cheeks (p < 0.001), chest (p = 0.007), back (p = 0.025) and forearm (p < 0.001). In females, α-γ thickness of the back was greater (p = 0.005). In old people compared to young, we noticed an increase of α-β layer at forehead and chest (p = 0.014), an increase of α-γ layer at forearm (p = 0.001), back (p = 0.024) and leg (p = 0.010) and an increase of α-δ layer at forehead (p = 0.001) and nose (p = 0.049). UHFUS is an advanced imaging technique that can detect both the DEJ and the boundary between dermis and subcutaneous tissue so that epidermal and dermal thickness can be measured with good accuracy. Regarding gender and age, skin differences obtained with UHFUS were comparable to other non-invasive methods.
传统高频超声（HFUS；20MHz）是一种用于活体皮肤研究的非侵入性方法，但无法准确测量皮肤厚度并识别表皮-真皮交界处（DEJ）。超高频超声（UHFUS；70-100MHz）具有与组织学相当的亚毫米分辨率。本研究的目的是通过 UHFUS 识别 DEJ，并根据年龄和性别提供皮肤厚度的测量值，从而描述健康个体的皮肤差异。我们还描述了大疱性类天疱疮病变。我们招募了 42 名患者，分为两组：A 组和 B 组。A 组包括 32 名年龄在 22-74 岁的健康志愿者。B 组包括 10 名大疱性类天疱疮患者。对于 A 组的每位患者，我们在额部、脸颊、鼻子、前臂、腹部、胸部、背部和腿部使用 70MHz 探头进行了 8 次超声（US）剪辑。对于 B 组的每位患者，我们在水疱顶部和边缘采集了 5 个 US 图像。在每个 US 图像中，我们测量了角质层（α-β）、表皮（α-γ）和表皮加真皮（α-δ）的厚度。在两组中，我们都发现了 4 条线来划分：角质层（α 线和 β 线之间的层）、表皮（α 和 γ 线之间的距离）和真皮和皮下组织之间的边界（δ 线）。γ 线对应于疱的分离点。男性腹部的α-β层较厚（p=0.019），脸颊（p<0.001）、胸部（p=0.007）、背部（p=0.025）和前臂（p<0.001）的α-δ 厚度也较厚。女性背部的α-γ 厚度较大（p=0.005）。与年轻人相比，老年人额部和胸部的α-β 层增加（p=0.014），前臂（p=0.001）、背部（p=0.024）和腿部（p=0.010）的α-γ 层增加，额部（p=0.001）和鼻子（p=0.049）的α-δ 层增加。UHFUS 是一种先进的成像技术，可同时检测 DEJ 和真皮与皮下组织之间的边界，从而可以准确测量表皮和真皮的厚度。关于性别和年龄，UHFUS 获得的皮肤差异与其他非侵入性方法相当。
