Department of Dermatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Department of Imaging, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile.
J Cutan Med Surg. 2023 Sep-Oct;27(5):454-460. doi: 10.1177/12034754231191474. Epub 2023 Aug 2.
Detection of activity in morphea is paramount for adequately managing the disease. Subclinical ultrasound involvement on inactive lesions or healthy skin areas adjacent to morphea has not been described to date.
The study aimed to detect morphea's subclinical activity by Color Doppler ultrasound not identified with the clinical scorings.
MATERIALS & METHODS: This cross-sectional retrospective study was done from January 2014 to July 2019 in patients with a clinicopathological diagnosis of morphea. The modified Localized Scleroderma Skin Severity Index (mLoSSI) and The Ultrasound Morphea Activity Score (US-MAS) were used to correlate clinical and subclinical activity.
A total of 36 patients met the inclusion criteria. 54% of cases presented subclinical activity in areas adjacent to the clinically active lesion, 23% in nonadjacent regions, and 23% demonstrated activity at a clinically inactive lesion site.100% of patients with morphea "en coup de sabre" involving the frontal region of the face concomitantly presented both subclinical activities of morphea on the frontal facial region and the scalp following the same axis.A positive relationship was observed between the degree of clinical activity measured by mLoSSI and US-MAS scoring.The main limitations of our study were the low number of patients and the inability to detect alterations < 0.1 mm.
Subclinical activity is frequent in morphea, can extend beyond the lesional areas, including apparently noninvolved adjacent and distant corporal regions, and can be detected by color Doppler ultrasound.
检测硬斑病的活动对于充分管理疾病至关重要。迄今为止，尚未描述无临床评分的亚临床超声在静止性病变或紧邻硬斑病的健康皮肤区域的参与情况。
本研究旨在通过彩色多普勒超声检测未被临床评分识别的硬斑病的亚临床活动。
这是一项从 2014 年 1 月至 2019 年 7 月进行的横断面回顾性研究，研究对象为具有硬斑病临床病理诊断的患者。使用改良局部硬皮病皮肤严重程度指数（mLoSSI）和超声硬斑病活动评分（US-MAS）来关联临床和亚临床活动。
共有 36 名患者符合纳入标准。54%的病例在临床活动病变的相邻区域存在亚临床活动，23%在非相邻区域存在亚临床活动，23%在临床无活动病变部位存在亚临床活动。100%的面部额部“砍凿状硬斑病”患者同时在额面部和同一轴线上的头皮出现硬斑病的亚临床活动。通过 mLoSSI 和 US-MAS 评分测量的临床活动程度之间观察到正相关关系。本研究的主要局限性是患者数量少，无法检测<0.1mm 的变化。
硬斑病的亚临床活动很常见，可扩展到病变区域之外，包括明显无受累的相邻和远处躯体区域，并且可以通过彩色多普勒超声检测到。
