Usefulness of high‐frequency ultrasonography in the evaluation and monitoring of sclerosing dermatoses: a cohort study
Summary Background Monitoring of disease activity in sclerosing dermatoses (SD) can be challenging and tools to support clinical decision‐making are lacking. Aim To analyse the impact of high‐frequency ultrasonography (HFUS) on the clinical management of SD and to describe the US characteristics of...
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| Veröffentlicht in: | Clinical and experimental dermatology 2022-02, Vol.47 (2), p.351-358 |
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| creator | Marti‐Marti, I. Morgado‐Carrasco, D. Podlipnik, S. Rizo‐Potau, D. Bosch‐Amate, X. Lledó, G. M. Suárez‐Lledó, M. Espinosa, G. Martínez, C. Mascaró, J. M. Giavedoni, P. |
| description | Summary
Background
Monitoring of disease activity in sclerosing dermatoses (SD) can be challenging and tools to support clinical decision‐making are lacking.
Aim
To analyse the impact of high‐frequency ultrasonography (HFUS) on the clinical management of SD and to describe the US characteristics of disease activity.
Methods
This was a cohort study of patients with various SD [morphoea, systemic sclerosis (SS) and chronic graft‐versus‐host disease (cGvHD)] who underwent HFUS between January 2017 and August 2019. HFUS criteria for diagnosing active SD were increased Doppler vascularity and/or meeting all B‐mode greyscale US signs of activity. Discordance in SD activity between HFUS and clinical examination was evaluated at the time of the first US assessment. Changes in patient management were instituted after HFUS were recorded.
Results
In total, 72 patients (31 with morphoea, 19 with SS and 22 with cGvHD), who underwent 163 HFUS sessions in total, were included. All HFUS‐active morphoea lesions exhibited increased vascularity, and all HFUS‐active SS exhibited dermal thickening and dermal hypoechogenicity. HFUS‐active cGvHD displayed increased dermal thickness and loss of definition of the dermal–hypodermal junction, and there were signs of panniculitis in 80% of cases and of increased vascularity in 70%. Discordance in disease activity between clinical and HFUS evaluation was found in 17 (23.6%) patients. Changes in clinical management after HFUS were made for 14 (19.4%) patients: treatment discontinuation for 6 patients (42.9%), treatment initiation for 5 (35.7%), medication change for 2 (14.3%) and skin biopsy taken for 1 (7.1%).
Conclusion
HFUS seems an efficacious support tool in the monitoring of SD activity with a notable impact on clinical management. Further studies are warranted to evaluate the impact of HFUS‐supported management changes on SD outcomes.
This study describes the ultrasonographic characteristics of disease activity in sclerosing dermatoses (morphoea, systemic sclerosis and chronic graft‐versus‐host disease) and suggests that high‐frequency ultrasonography can be a useful tool in the follow‐up of sclerosing dermatoses and may influence their clinical management. |
| doi_str_mv | 10.1111/ced.14903 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2564490062</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2564490062</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3533-1f067b3818794a3cb92999ffd749a2f6f8887334c4f45c35a58ebbd6ebcbc5093</originalsourceid><addsrcrecordid>eNp1kc1O3DAURq2qqAy0i75AZakbugjY8U_i7qophUpIbGBtOc71JCixp3ZSyI5H6DP2SfB0YFMJbyzbx0f33g-hj5Sc0rzOLLSnlCvC3qAVZVIUZcnIW7QijFSFVKw-REcp3RFCGa3EO3TIOGdUCLlCD7cJ3Dx4SAkHh7t-0_19_OMi_JrB2wXPwxRNCj5sotl2C-49njrA8NsMs5n64LHxLR6D76cQe7_ZSZIdIIa0O7UQRzOFBOkrNtiGLsQJp2lul_fowJkhwYfn_Rjd_ji_WV8WV9cXP9ffrgrLBGMFdURWDatpXSlumG1UqZRyrq24MqWTrq7rijFuueMifzGihqZpJTS2sYIodoxO9t5tDLmnNOmxTxaGwXgIc9KlkDyPjsgyo5__Q-_CHH2uTpf5uaoko3Wmvuwpm3tMEZzexn40cdGU6F0cOseh_8WR2U_PxrkZ8-0L-TL_DJztgft-gOV1k16ff98rnwDctpaL</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2623776318</pqid></control><display><type>article</type><title>Usefulness of high‐frequency ultrasonography in the evaluation and monitoring of sclerosing dermatoses: a cohort study</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Marti‐Marti, I. ; Morgado‐Carrasco, D. ; Podlipnik, S. ; Rizo‐Potau, D. ; Bosch‐Amate, X. ; Lledó, G. M. ; Suárez‐Lledó, M. ; Espinosa, G. ; Martínez, C. ; Mascaró, J. M. ; Giavedoni, P.</creator><creatorcontrib>Marti‐Marti, I. ; Morgado‐Carrasco, D. ; Podlipnik, S. ; Rizo‐Potau, D. ; Bosch‐Amate, X. ; Lledó, G. M. ; Suárez‐Lledó, M. ; Espinosa, G. ; Martínez, C. ; Mascaró, J. M. ; Giavedoni, P.</creatorcontrib><description>Summary
Background
Monitoring of disease activity in sclerosing dermatoses (SD) can be challenging and tools to support clinical decision‐making are lacking.
Aim
To analyse the impact of high‐frequency ultrasonography (HFUS) on the clinical management of SD and to describe the US characteristics of disease activity.
Methods
This was a cohort study of patients with various SD [morphoea, systemic sclerosis (SS) and chronic graft‐versus‐host disease (cGvHD)] who underwent HFUS between January 2017 and August 2019. HFUS criteria for diagnosing active SD were increased Doppler vascularity and/or meeting all B‐mode greyscale US signs of activity. Discordance in SD activity between HFUS and clinical examination was evaluated at the time of the first US assessment. Changes in patient management were instituted after HFUS were recorded.
Results
In total, 72 patients (31 with morphoea, 19 with SS and 22 with cGvHD), who underwent 163 HFUS sessions in total, were included. All HFUS‐active morphoea lesions exhibited increased vascularity, and all HFUS‐active SS exhibited dermal thickening and dermal hypoechogenicity. HFUS‐active cGvHD displayed increased dermal thickness and loss of definition of the dermal–hypodermal junction, and there were signs of panniculitis in 80% of cases and of increased vascularity in 70%. Discordance in disease activity between clinical and HFUS evaluation was found in 17 (23.6%) patients. Changes in clinical management after HFUS were made for 14 (19.4%) patients: treatment discontinuation for 6 patients (42.9%), treatment initiation for 5 (35.7%), medication change for 2 (14.3%) and skin biopsy taken for 1 (7.1%).
Conclusion
HFUS seems an efficacious support tool in the monitoring of SD activity with a notable impact on clinical management. Further studies are warranted to evaluate the impact of HFUS‐supported management changes on SD outcomes.
This study describes the ultrasonographic characteristics of disease activity in sclerosing dermatoses (morphoea, systemic sclerosis and chronic graft‐versus‐host disease) and suggests that high‐frequency ultrasonography can be a useful tool in the follow‐up of sclerosing dermatoses and may influence their clinical management.</description><identifier>ISSN: 0307-6938</identifier><identifier>EISSN: 1365-2230</identifier><identifier>DOI: 10.1111/ced.14903</identifier><identifier>PMID: 34431556</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Aged ; Biopsy ; Cohort analysis ; Cohort Studies ; Decision making ; Discordance ; Disease management ; Female ; Graft vs Host Disease - diagnostic imaging ; Humans ; Male ; Middle Aged ; Patients ; Scleroderma ; Scleroderma, Localized - diagnostic imaging ; Scleroderma, Systemic - diagnostic imaging ; Skin ; Skin - diagnostic imaging ; Skin - pathology ; Skin diseases ; Systemic sclerosis ; Ultrasonic imaging ; Ultrasonography - methods</subject><ispartof>Clinical and experimental dermatology, 2022-02, Vol.47 (2), p.351-358</ispartof><rights>2021 British Association of Dermatologists</rights><rights>2021 British Association of Dermatologists.</rights><rights>Copyright © 2022 British Association of Dermatologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3533-1f067b3818794a3cb92999ffd749a2f6f8887334c4f45c35a58ebbd6ebcbc5093</citedby><cites>FETCH-LOGICAL-c3533-1f067b3818794a3cb92999ffd749a2f6f8887334c4f45c35a58ebbd6ebcbc5093</cites><orcidid>0000-0003-4150-0522 ; 0000-0002-4809-8866 ; 0000-0002-6838-6160</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34431556$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marti‐Marti, I.</creatorcontrib><creatorcontrib>Morgado‐Carrasco, D.</creatorcontrib><creatorcontrib>Podlipnik, S.</creatorcontrib><creatorcontrib>Rizo‐Potau, D.</creatorcontrib><creatorcontrib>Bosch‐Amate, X.</creatorcontrib><creatorcontrib>Lledó, G. M.</creatorcontrib><creatorcontrib>Suárez‐Lledó, M.</creatorcontrib><creatorcontrib>Espinosa, G.</creatorcontrib><creatorcontrib>Martínez, C.</creatorcontrib><creatorcontrib>Mascaró, J. M.</creatorcontrib><creatorcontrib>Giavedoni, P.</creatorcontrib><title>Usefulness of high‐frequency ultrasonography in the evaluation and monitoring of sclerosing dermatoses: a cohort study</title><title>Clinical and experimental dermatology</title><addtitle>Clin Exp Dermatol</addtitle><description>Summary
Background
Monitoring of disease activity in sclerosing dermatoses (SD) can be challenging and tools to support clinical decision‐making are lacking.
Aim
To analyse the impact of high‐frequency ultrasonography (HFUS) on the clinical management of SD and to describe the US characteristics of disease activity.
Methods
This was a cohort study of patients with various SD [morphoea, systemic sclerosis (SS) and chronic graft‐versus‐host disease (cGvHD)] who underwent HFUS between January 2017 and August 2019. HFUS criteria for diagnosing active SD were increased Doppler vascularity and/or meeting all B‐mode greyscale US signs of activity. Discordance in SD activity between HFUS and clinical examination was evaluated at the time of the first US assessment. Changes in patient management were instituted after HFUS were recorded.
Results
In total, 72 patients (31 with morphoea, 19 with SS and 22 with cGvHD), who underwent 163 HFUS sessions in total, were included. All HFUS‐active morphoea lesions exhibited increased vascularity, and all HFUS‐active SS exhibited dermal thickening and dermal hypoechogenicity. HFUS‐active cGvHD displayed increased dermal thickness and loss of definition of the dermal–hypodermal junction, and there were signs of panniculitis in 80% of cases and of increased vascularity in 70%. Discordance in disease activity between clinical and HFUS evaluation was found in 17 (23.6%) patients. Changes in clinical management after HFUS were made for 14 (19.4%) patients: treatment discontinuation for 6 patients (42.9%), treatment initiation for 5 (35.7%), medication change for 2 (14.3%) and skin biopsy taken for 1 (7.1%).
Conclusion
HFUS seems an efficacious support tool in the monitoring of SD activity with a notable impact on clinical management. Further studies are warranted to evaluate the impact of HFUS‐supported management changes on SD outcomes.
This study describes the ultrasonographic characteristics of disease activity in sclerosing dermatoses (morphoea, systemic sclerosis and chronic graft‐versus‐host disease) and suggests that high‐frequency ultrasonography can be a useful tool in the follow‐up of sclerosing dermatoses and may influence their clinical management.</description><subject>Adult</subject><subject>Aged</subject><subject>Biopsy</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Decision making</subject><subject>Discordance</subject><subject>Disease management</subject><subject>Female</subject><subject>Graft vs Host Disease - diagnostic imaging</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Scleroderma</subject><subject>Scleroderma, Localized - diagnostic imaging</subject><subject>Scleroderma, Systemic - diagnostic imaging</subject><subject>Skin</subject><subject>Skin - diagnostic imaging</subject><subject>Skin - pathology</subject><subject>Skin diseases</subject><subject>Systemic sclerosis</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography - methods</subject><issn>0307-6938</issn><issn>1365-2230</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1O3DAURq2qqAy0i75AZakbugjY8U_i7qophUpIbGBtOc71JCixp3ZSyI5H6DP2SfB0YFMJbyzbx0f33g-hj5Sc0rzOLLSnlCvC3qAVZVIUZcnIW7QijFSFVKw-REcp3RFCGa3EO3TIOGdUCLlCD7cJ3Dx4SAkHh7t-0_19_OMi_JrB2wXPwxRNCj5sotl2C-49njrA8NsMs5n64LHxLR6D76cQe7_ZSZIdIIa0O7UQRzOFBOkrNtiGLsQJp2lul_fowJkhwYfn_Rjd_ji_WV8WV9cXP9ffrgrLBGMFdURWDatpXSlumG1UqZRyrq24MqWTrq7rijFuueMifzGihqZpJTS2sYIodoxO9t5tDLmnNOmxTxaGwXgIc9KlkDyPjsgyo5__Q-_CHH2uTpf5uaoko3Wmvuwpm3tMEZzexn40cdGU6F0cOseh_8WR2U_PxrkZ8-0L-TL_DJztgft-gOV1k16ff98rnwDctpaL</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Marti‐Marti, I.</creator><creator>Morgado‐Carrasco, D.</creator><creator>Podlipnik, S.</creator><creator>Rizo‐Potau, D.</creator><creator>Bosch‐Amate, X.</creator><creator>Lledó, G. M.</creator><creator>Suárez‐Lledó, M.</creator><creator>Espinosa, G.</creator><creator>Martínez, C.</creator><creator>Mascaró, J. M.</creator><creator>Giavedoni, P.</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4150-0522</orcidid><orcidid>https://orcid.org/0000-0002-4809-8866</orcidid><orcidid>https://orcid.org/0000-0002-6838-6160</orcidid></search><sort><creationdate>202202</creationdate><title>Usefulness of high‐frequency ultrasonography in the evaluation and monitoring of sclerosing dermatoses: a cohort study</title><author>Marti‐Marti, I. ; Morgado‐Carrasco, D. ; Podlipnik, S. ; Rizo‐Potau, D. ; Bosch‐Amate, X. ; Lledó, G. M. ; Suárez‐Lledó, M. ; Espinosa, G. ; Martínez, C. ; Mascaró, J. M. ; Giavedoni, P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3533-1f067b3818794a3cb92999ffd749a2f6f8887334c4f45c35a58ebbd6ebcbc5093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biopsy</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Decision making</topic><topic>Discordance</topic><topic>Disease management</topic><topic>Female</topic><topic>Graft vs Host Disease - diagnostic imaging</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Scleroderma</topic><topic>Scleroderma, Localized - diagnostic imaging</topic><topic>Scleroderma, Systemic - diagnostic imaging</topic><topic>Skin</topic><topic>Skin - diagnostic imaging</topic><topic>Skin - pathology</topic><topic>Skin diseases</topic><topic>Systemic sclerosis</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marti‐Marti, I.</creatorcontrib><creatorcontrib>Morgado‐Carrasco, D.</creatorcontrib><creatorcontrib>Podlipnik, S.</creatorcontrib><creatorcontrib>Rizo‐Potau, D.</creatorcontrib><creatorcontrib>Bosch‐Amate, X.</creatorcontrib><creatorcontrib>Lledó, G. M.</creatorcontrib><creatorcontrib>Suárez‐Lledó, M.</creatorcontrib><creatorcontrib>Espinosa, G.</creatorcontrib><creatorcontrib>Martínez, C.</creatorcontrib><creatorcontrib>Mascaró, J. M.</creatorcontrib><creatorcontrib>Giavedoni, P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marti‐Marti, I.</au><au>Morgado‐Carrasco, D.</au><au>Podlipnik, S.</au><au>Rizo‐Potau, D.</au><au>Bosch‐Amate, X.</au><au>Lledó, G. M.</au><au>Suárez‐Lledó, M.</au><au>Espinosa, G.</au><au>Martínez, C.</au><au>Mascaró, J. M.</au><au>Giavedoni, P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Usefulness of high‐frequency ultrasonography in the evaluation and monitoring of sclerosing dermatoses: a cohort study</atitle><jtitle>Clinical and experimental dermatology</jtitle><addtitle>Clin Exp Dermatol</addtitle><date>2022-02</date><risdate>2022</risdate><volume>47</volume><issue>2</issue><spage>351</spage><epage>358</epage><pages>351-358</pages><issn>0307-6938</issn><eissn>1365-2230</eissn><abstract>Summary
Background
Monitoring of disease activity in sclerosing dermatoses (SD) can be challenging and tools to support clinical decision‐making are lacking.
Aim
To analyse the impact of high‐frequency ultrasonography (HFUS) on the clinical management of SD and to describe the US characteristics of disease activity.
Methods
This was a cohort study of patients with various SD [morphoea, systemic sclerosis (SS) and chronic graft‐versus‐host disease (cGvHD)] who underwent HFUS between January 2017 and August 2019. HFUS criteria for diagnosing active SD were increased Doppler vascularity and/or meeting all B‐mode greyscale US signs of activity. Discordance in SD activity between HFUS and clinical examination was evaluated at the time of the first US assessment. Changes in patient management were instituted after HFUS were recorded.
Results
In total, 72 patients (31 with morphoea, 19 with SS and 22 with cGvHD), who underwent 163 HFUS sessions in total, were included. All HFUS‐active morphoea lesions exhibited increased vascularity, and all HFUS‐active SS exhibited dermal thickening and dermal hypoechogenicity. HFUS‐active cGvHD displayed increased dermal thickness and loss of definition of the dermal–hypodermal junction, and there were signs of panniculitis in 80% of cases and of increased vascularity in 70%. Discordance in disease activity between clinical and HFUS evaluation was found in 17 (23.6%) patients. Changes in clinical management after HFUS were made for 14 (19.4%) patients: treatment discontinuation for 6 patients (42.9%), treatment initiation for 5 (35.7%), medication change for 2 (14.3%) and skin biopsy taken for 1 (7.1%).
Conclusion
HFUS seems an efficacious support tool in the monitoring of SD activity with a notable impact on clinical management. Further studies are warranted to evaluate the impact of HFUS‐supported management changes on SD outcomes.
This study describes the ultrasonographic characteristics of disease activity in sclerosing dermatoses (morphoea, systemic sclerosis and chronic graft‐versus‐host disease) and suggests that high‐frequency ultrasonography can be a useful tool in the follow‐up of sclerosing dermatoses and may influence their clinical management.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>34431556</pmid><doi>10.1111/ced.14903</doi><tpages>358</tpages><orcidid>https://orcid.org/0000-0003-4150-0522</orcidid><orcidid>https://orcid.org/0000-0002-4809-8866</orcidid><orcidid>https://orcid.org/0000-0002-6838-6160</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0307-6938 |
| ispartof | Clinical and experimental dermatology, 2022-02, Vol.47 (2), p.351-358 |
| issn | 0307-6938 1365-2230 |
| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Aged Biopsy Cohort analysis Cohort Studies Decision making Discordance Disease management Female Graft vs Host Disease - diagnostic imaging Humans Male Middle Aged Patients Scleroderma Scleroderma, Localized - diagnostic imaging Scleroderma, Systemic - diagnostic imaging Skin Skin - diagnostic imaging Skin - pathology Skin diseases Systemic sclerosis Ultrasonic imaging Ultrasonography - methods |
| title | Usefulness of high‐frequency ultrasonography in the evaluation and monitoring of sclerosing dermatoses: a cohort study |
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