Possibilities of skin ultrasound examination in the management of patients with localized scleroderma

With the help of ultrasound examination (ultrasound), it is possible to visualize the skin of patients with suspected localized scleroderma, as well as to objectively determine the stage of the disease and assess the effectiveness of therapy.

Three patients with linear, plaque forms of scleroderma, as well as lichen sclerosus, underwent skin ultrasound using a Skinscanner DUB TPM device with a 75 MHz transducer, 4 mm penetration, 21 μm resolution in the area of lesions and in adjacent areas of healthy skin, using their ratio coefficient (RC) for comparative evaluation. The thickness of the epidermis and dermis, their echogenicity were determined.

With a linear form of scleroderma, an increase in the thickness of the epidermis in the area of the focus (RC 0.85±0.0125) and a decrease in its echogenicity (RC 1.58±0.46) were observed. The echogenicity of the dermis was significantly reduced in the lesion (RC 3.02±1.17). The dermis thickness was slightly less in the center of the lesion (RC 1.09), at the periphery of the lesion it was moderately increased (RC 0.86). In the plaque form of scleroderma, a decrease in the echogenicity of the epidermis was observed in the foci (RC 1.32±0.49); an increase in the thickness of the dermis (RC 0.79±0.16) and a decrease in its e echogenicity (RC 1.26±0.57). In 7 of 11 foci, a subepidermal hypoechoic band was visualized. With lichen sclerosis in the foci, an increase in the thickness of the epidermis (RC 0.42±0.12) and its acoustic density (RC 0.63±0.0793), a decrease in the thickness and echo density of the dermis (RC 1.32±0.00943 and RC 1.55±0.6, respectively).

With different forms of LS, a different ultrasound picture was observed, depending on the stage and activity of the process. The changes identified during treatment reflect the effectiveness of the therapy and the rate of restoration of the skin structure during therapy.