Pain Clare E, Murray Andrea, Dinsdale Graham, Marsden Antonia, Manning Joanne, Riley Phil, Leone Valentina, Amin Tania, Zulian Francesco, Herrick Ariane L
Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
Rheumatology (Oxford). 2024 May 2;63(5):1332-1340. doi: 10.1093/rheumatology/kead380.
To evaluate whether in juvenile localized scleroderma (JLS), non-invasive imaging can differentiate affected from non-affected skin and whether imaging correlates with a validated skin score [Localised Scleroderma Cutaneous Assessment Tool (LoSCAT)].
A total of 25 children with JLS were recruited into a prospective study and a single 'target' lesion was selected. High-frequency ultrasound (HFUS, measuring skin thickness), infrared thermography (IRT, skin temperature), laser Doppler imaging (LDI, skin blood flow) and multispectral imaging (MSI, oxygenation) were performed at four sites: two of affected skin (centre and inner edge of lesion) and two of non-affected skin (1 cm from the edge of the lesion 'outer' and contralateral non-affected side) at four visits at 3 month intervals.
Differences between affected and non-affected skin were detected with all four techniques. Compared with non-affected skin, affected skin was thinner (P < 0.001), with higher temperature (P < 0.001-0.006), perfusion (P < 0.001-0.039) and oxygenation (P < 0.001-0.028). Lesion skin activity (LoSCAT) was positively correlated with centre HFUS [r = 0.32 (95% CI 0.02, 0.61), P = 0.036] and negatively correlated with centre LDI [r = -0.26 (95% CI -0.49, -0.04), P = 0.022]. Lesion skin damage was positively correlated with centre and inner IRT [r = 0.43 (95% CI 0.19, 0.67), P < 0.001 and r = 0.36 (95% CI 0.12, 0.59), P = 0.003, respectively] and with centre and inner LDI [r = 0.37 (95% CI 0.05, 0.69), P = 0.024 and r = 0.41 (95% CI 0.08, 0.74), P = 0.015, respectively].
Non-invasive imaging can detect differences between affected and non-affected skin in JLS and may help to differentiate between activity (thicker, less well-perfused skin) and damage (thinner, highly perfused skin).
评估在青少年局限性硬皮病（JLS）中，非侵入性成像能否区分受累皮肤和未受累皮肤，以及成像是否与经过验证的皮肤评分[局限性硬皮病皮肤评估工具（LoSCAT）]相关。
共招募了25名患有JLS的儿童参与一项前瞻性研究，并选择了单个“目标”病变。在四个部位进行高频超声（HFUS，测量皮肤厚度）、红外热成像（IRT，皮肤温度）、激光多普勒成像（LDI，皮肤血流）和多光谱成像（MSI，氧合）：病变皮肤的两个部位（病变中心和内边缘）以及未受累皮肤的两个部位（距病变边缘“外侧”1厘米处和对侧未受累侧），每3个月进行4次检查。
所有四种技术均检测到受累皮肤和未受累皮肤之间的差异。与未受累皮肤相比，受累皮肤更薄（P<0.001），温度更高（P<0.001-0.006），灌注更高（P<(0.001-0.039)），氧合更高（P<(0.001-0.028)）。病变皮肤活动度（LoSCAT）与中心HFUS呈正相关[r = 0.32（95%CI 0.02，0.61），P = 0.036]，与中心LDI呈负相关[r = -0.26（95%CI -0.49，-0.04），P = 0.022]。病变皮肤损伤与中心和内侧IRT呈正相关[r = 0.43（95%CI 0.19，0.67），P<0.001和r = 0.36（95%CI 0.12，0.59），P = 0.003]，与中心和内侧LDI也呈正相关[r = 0.37（95%CI 0.05，0.69），P = 0.024和r = 0.41（95%CI 0.08，0.74），P = 0.015]。
非侵入性成像可以检测JLS中受累皮肤和未受累皮肤之间的差异，并可能有助于区分活动期（皮肤更厚、灌注较差）和损伤期（皮肤更薄、灌注良好）。
