The Value of Ultrasonography in the Diagnosis and Monitoring of Localized Morphea — Case Report

AbstractIntroduction:The aim of this presentation is to highlight the usefulness of high-frequency ultrasound (18 MHz) in localized morphea for: identification of the lesion, guided skin biopsy, quantification of skin thickness, evaluating the severity by measuring total echogenicity.Case presentation:A 62-year-old Caucasian woman was referred to the Dermatology Department for a well-circumscribed indurate plaque localized on the right side of the abdominal wall and thigh. On clinical examination, a large well-delimited, indurate plaque, silvery in the center and surrounded by a purplish-red halo (lilac ring) was noticed on the right side of the abdomen and thigh. An ultrasound-guided punch biopsy was carried out and the microscopic examination of the biopsy revealed moderate interstitial inflammatory infiltrate together with abundant collagen bundles in the dermis and subcutis and a diagnosis of localized morphea (scleroderma) was established. Ultrasonography was performed and skin thickness was measured using high-frequency US (18 MHz) and was found to be 3.1 mm to 3.9 mm.Conclusion:high frequency ultrasound is an inexpensive, easy to perform, noninvasive method, replacing surgical biopsy and offering a valuable quantification of skin fibrosis.

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Morphologic Features of Cutaneous T-Cell Lymphomas Using Dermoscopy and High Frequency Ultrasound

Journal of Clinical Medicine ◽

10.3390/jcm10010017 ◽

2020 ◽

Vol 10 (1) ◽

pp. 17

Author(s):

Iris Wohlmuth-Wieser ◽

Joel M. Ramjist ◽

Neil Shear ◽

Raed Alhusayen

Keyword(s):

T Cell ◽

High Frequency ◽

Early Stage ◽

Skin Lesions ◽

Diagnostic Tools ◽

Skin Thickness ◽

High Frequency Ultrasound ◽

T Cell Lymphomas ◽

Standardized Parameters ◽

Frequency Ultrasound

The diagnosis of cutaneous T-cell lymphomas (CTCL) is frequently delayed by a median of three years and requires the clinical evaluation of an experienced dermatologist and a confirmatory skin biopsy. Dermoscopy and high-frequency ultrasound (HFUS) represent two non-invasive diagnostic tools. While dermoscopy is inexpensive and widely used for the diagnosis of melanoma and non-melanoma skin cancers, HFUS of skin lymphomas represents a novel diagnostic approach that is not yet implemented in the routine dermatologic practice. The aim of our study was to prospectively assess skin lesions of patients with either CTCL patches or plaques with dermoscopy and HFUS and to compare the findings with atopic dermatitis (AD) and psoriasis. Thirteen patients with an established diagnosis of CTCL, psoriasis, or AD were studied: Dermoscopy features including spermatozoa-like structures and the presence of white scales could assist in differentiating between early-stage CTCL and AD. HFUS measurements of the skin thickness indicated increased epidermal-, thickness in CTCL, and psoriasis compared with AD. Our results support the use of dermoscopy as a useful tool to diagnose CTCL. HFUS could augment the dermatologic assessment, but further studies will be needed to define standardized parameters.

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Differential criteria for clinical manifestations of biliary dyskinesia and chronic cholecystitis

NATURE AND SCIENCE ◽

10.36719/2707-1146/06/32-34 ◽

2021 ◽

Vol 03 (01) ◽

pp. 32-34

Author(s):

Ağaşirin Aydın oğlu Rüstəmov ◽

◽

Fatma Fatma Oruc qızı Rəcəbova7............ ◽

Keyword(s):

Early Diagnosis ◽

High Frequency ◽

Ultrasound Examination ◽

Clinical Manifestations ◽

Chronic Cholecystitis ◽

High Frequency Ultrasound ◽

Laboratory Methods ◽

Dyspeptic Symptoms ◽

The Right ◽

Frequency Ultrasound

For the diagnosis and differentiation of chronic cholesistoxolangiitis from the diseases of the biliary system, 20 patients used modern instrumental and laboratory methods. In these methods, excision cholesistorentgenography, retrograde cholangiography, high frequency ultrasound examination, and cholesterol in the blood, manometric tonometry. In the objective examination, patients were disturbed by the pain on the right side of the neck, on the right side of the breast and in the right rib. Dyspeptic symptoms such as lower appetite, nausea, vomiting, and meteorism have been discovered. Dietotherapy, spasmolitics, antibiotics, gallbladder and physiotherapy have also been used in the treatment. Thus, based on the results of our examination, it is recommended that they be used in early diagnosis of chronic cholesistoxolangitis. Key words: cholangiocholecystitis, gallbladder, symptoms, clinical, diagnosis

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High frequency ultrasound assessment of systemic sclerosis skin involvement: intra-observer repeatability and relationship with clinician assessment and dermal collagen content

The Journal of Rheumatology ◽

10.3899/jrheum.200234 ◽

2020 ◽

pp. jrheum.200234

Author(s):

Victoria A. Flower ◽

Shaney L. Barratt ◽

Darren J. Hart ◽

Amanda B. Mackenzie ◽

Jacqueline A. Shipley ◽

...

Keyword(s):

Systemic Sclerosis ◽

High Frequency ◽

Convergent Validity ◽

Objective Assessment ◽

Collagen Content ◽

Skin Thickness ◽

High Frequency Ultrasound ◽

Dermal Collagen ◽

The Relationship ◽

Frequency Ultrasound

Objective The modified Rodnan skin score (mRSS) remains the preferred method for skin assessment in systemic sclerosis (SSc). There are concerns regarding high inter-observer variability of mRSS and negative clinical trials utilising mRSS as the primary endpoint. High frequency ultrasound (HFUS) allows objective assessment of cutaneous fibrosis in SSc. We investigated the relationship between HFUS with both mRSS and dermal collagen. Methods Skin thickness (ST), echogenicity and novel Shear wave elastography (SWE) were assessed in 53 SSc patients and 15 healthy controls (HC) at the finger, hand, forearm and abdomen. The relationship between HFUS parameters with mRSS (n=53) and dermal collagen (10 SSc patients and 10 HC) was investigated. Intra-observer repeatability of HFUS was calculated using intra-class correlation coefficients (ICCs). Results HFUS assessment of ST (hand/forearm) and SWE (finger/hand) correlated with local mRSS at some sites. Subclinical abnormalities in ST, echogenicity and SWE were present in clinically uninvolved SSc skin. Additionally, changes in echogenicity and SWE were sometimes apparent despite objectively normal ST on HFUS. ST, SWE and local mRSS correlated strongly with collagen quantification (rho 0.697, 0.709, 0.649 respectively). Intra-observer repeatability was high for all HFUS parameters (ICCs for ST 0.946-0.978, echogenicity 0.648- 0.865 and SWE 0.953-0.973). Conclusion Our data demonstrates excellent reproducibility and reassuring convergent validity with dermal collagen content. Detection of subclinical abnormalities is an additional benefit of HFUS. The observed correlations with collagen quantification support further investigation of HFUS as an alternative to mRSS in clinical trial settings.

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P162 Cross-validation and complementary value of optical coherence tomography and high frequency ultrasound for the assessment of skin disease in systemic sclerosis

Rheumatology ◽

10.1093/rheumatology/keaa111.157 ◽

2020 ◽

Vol 59 (Supplement_2) ◽

Author(s):

Duygu Temiz Karadag ◽

Giovanni Lettieri ◽

Valentina Picerno ◽

Ozcan Gundogdu ◽

Maria Carmela Padula ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Systemic Sclerosis ◽

Skin Disease ◽

High Frequency ◽

Skin Thickness ◽

Optical Coherence ◽

Skin Involvement ◽

High Frequency Ultrasound ◽

Complementary Value ◽

Frequency Ultrasound

Abstract Background The modified Rodnan skin score (mRSS) is the current gold standard for skin assessment in systemic sclerosis (SSc) both in clinical trials and practice. Several studies have reported that skin high frequency ultrasound (HFUS) and, more recently, optical coherence tomography (OCT) are able to reflect the severity of the skin disease in SSc. Aim of the study was to compare OCT and HFUS in the assessment of skin involvement in SSc. Methods Dorsal forearm skin of consecutive diffuse cutaneous SSc (dcSSc) patients and matched-healthy controls (HC) were scanned using OCT and HFUS by investigators blinded to the clinical details using Vivosight scanner (1 assessor) and Esaote MyLab70 equipped with a 22 MHZ probe (2 assessors) respectively. Minimum Optical Density (MinOD), Maximum OD (MaxOD) and OD at 300 micron-depth (OD300) (OCT) and skin thickness (HFUS) were measured. Clinical involvement was assessed by a blinded operator using the mRSS and results were cross matched with imaging data. Statistical analysis was performed using GraphPad Prism software V.7.0. Results A total of 88 OCT images and 176 HFUS images were obtained from 22 dcSSc patients [20 Female, mean age 49 (±11) years, 12 with < 5 years disease duration) and 22 HC (20 Female, mean age 50.7 (±6.7) years]. All OCT measures (MinOD, MaxOD and OD300) were significantly lower in SSc patients than in HC (p = 0.011, p < 0.0001, p < 0.0001 respectively). HFUS showed a lower performance in discriminating SSc skin vs HC compared to OCT (overall AUC 0.6 vs 0.72, 0.8 and 0.89 for MinOD, MaxOD and OD300 respectively). Nevertheless, mean HFUS skin thickness significantly correlated with mRSS at site of analysis (r = 0.47, p = 0.0013) and showed overall excellent interobserver reliability between assessors (ICC >0.8). Importantly, MaxOD and OD300 negatively correlated with HFUS skin thickness (r=-0.32, p = 0.035; r=-0.31, p = 0.039). Conclusion OCT of the skin has been previously validated against skin biopsy in SSc. Our results validate HFUS against OCT and indicate that HFUS of the skin is a reliable measure of skin involvement. Further, here we show that HFUS and OCT outperform each other in measuring different aspects of skin involvement in SSc and they offer complementary surrogate outcome measures of disease. Disclosures D. Temiz Karadag None. G. Lettieri None. V. Picerno None. O. Gundogdu None. M. Padula None. G.A. Mennillo None. A.A. Padula None. F. Del Galdo None. S. D'Angelo None. G. Abignano None.

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Measurement of the skin thickness using images of high-frequency ultrasound, in newborns v2 (protocols.io.nfgdbjw)

protocols.io ◽

10.17504/protocols.io.nfgdbjw ◽

2018 ◽

Author(s):

Gabriela Luiza ◽

Regina Am ◽

Ingrid Michelle ◽

Rodney Nascimento ◽

Zilma Silveira

Keyword(s):

High Frequency ◽

Skin Thickness ◽

High Frequency Ultrasound ◽

Frequency Ultrasound

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Photoacoustic and High-Frequency Ultrasound Imaging of Systemic Sclerosis Patients

10.21203/rs.3.rs-93714/v1 ◽

2020 ◽

Author(s):

Brigit E. Kersten ◽

Khalid Daoudi ◽

Cornelia H van den Ende ◽

Frank H van den Hoogen ◽

Chris L. de Korte ◽

...

Keyword(s):

Systemic Sclerosis ◽

Oxygen Saturation ◽

High Frequency ◽

Skin Thickness ◽

Healthy Individuals ◽

High Frequency Ultrasound ◽

The Third ◽

Significant Difference ◽

Primary Raynaud’S Phenomenon ◽

Frequency Ultrasound

Abstract Introduction: Systemic sclerosis starts with an early phase characterized by Raynauds phenomenon, puffy fingers/hands, autoantibodies and a scleroderma nailfoldmicroscopic pattern. Alterations in the nailfoldmicroscopic pattern are not evident in all early SSc patients. Photoacoustics(PA) and high-frequency ultrasound (HFUS) could fulfill this need. The former can measure oxygen saturation while the latter can measure skin thickening. We hypothesize that photoacoustics and high-frequency ultrasound can distinguish (early) SSc patients from individuals with primary Raynaud's phenomenon (PRP) by measuring oxygenation of the fingertip and skin thickening.Methods: We compared measurements of the third finger in (early)SSc patients to healthy and PRP individuals. The level of oxygenation and skin thickness were compared between groups. Nailfoldcapillaroscopy was performed on all subjects.Results: Thirty-one adult subjects participated in this study: twelve patients with SSc, 5 patients with early SSc, 5 volunteers with PR and 9 healthy controls. We found a significant difference in oxygen saturation between (early) SSc patients (80.8% ± 8.1 and 77,9% ± 10.5 ) and individuals with PRP (93.9% ± 1.1). Measurements of skin thickening showed a significant difference in (early) SSc patients compared to individuals with PRP (0.48 ± 0.06 mm and 0.51 ±0.16 mm vs. 0.27 ± 0.01 mm). There was no significant difference between healthy and PRP individuals in oxygenation or skin thickening.Conclusion: Photoacoustic and high-frequency ultrasound can distinguish between (early)SSc, PRP and healthy individuals in both oxygenation and skin thickening.

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Nevus sebaceus of Jadassohn - high frequency ultrasound imaging and videodermoscopy examination. Case presentation

Medicine and Pharmacy Reports ◽

10.15386/mpr-1658 ◽

2020 ◽

Author(s):

Artur Bezugly ◽

Tatiana Sedova ◽

Pavel Belkov ◽

Damir Enikeev ◽

Ruslan Voloshin

Keyword(s):

Malignant Transformation ◽

High Frequency ◽

Malignant Tumors ◽

Polarized Light ◽

High Frequency Ultrasound ◽

Case Presentation ◽

Unit Cells ◽

Nevus Sebaceus ◽

Necessary And Sufficient ◽

Frequency Ultrasound

Nevus sebaceus of Jadassohn (NSJ) is a congenital cutaneous hamartoma mainly developing from pilosebaceous unit cells. NSJ has the potential to develop into a variety of benign and malignant tumors, which are not limited to sebaceous differentiation. The dynamical monitoring for the earliest malignant transformation is necessary. Herein, we report the combined noninvasive NSJ examination with videodermoscopy in polarized and non-polarized light and high-frequency ultrasound (HFUS) imaging at 33 and 50 MHz. Typical NSJ dermoscopic signs where described, the internal nevus structure and its location, depths, and margins with surrounded tissues were examined with high-frequency ultrasound. Some HFUS characteristics for NSJ were described. Videodermoscopy and high-frequency ultrasound combined examination could be useful for NSJ dynamical monitoring in order to detect malignant transformation and to define necessary and sufficient tissue excision volume in case of surgical treatment.

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