Ultrasonographic Evaluation of Juvenile Localized Scleroderma: Enhancing Objectivity in Diagnosis and Management
Current Medical Imaging, cilt.20, 2024 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 20
- Basım Tarihi: 2024
- Doi Numarası: 10.2174/0115734056299155240516102231
- Dergi Adı: Current Medical Imaging
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Anahtar Kelimeler: Childhood, Dermis, Lesion staging, Localized scleroderma, Subcutaneous tissue, Ultrasound
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Although clinical assessment has historically been the primary method used for diagnosing and staging pediatric localized scleroderma (LS), high-frequency ultrasonography (HFUS) is being investigated as a more accurate method for evaluating lesions. Objectives: This study aimed to assess, compare dermal and subcutaneous tissue characteristics and enhance lesion staging in pediatric LS patients using HFUS. Methods: Twenty two LS patients were cross-sectionally evaluated with B-mode ultrasonography. Lesions were clinically staged, and dermal and subcutaneous tissue characteristics were compared with healthy tissue using HFUS. Results: Among 55 lesions, 27 were active/new (49.1%), and 28 were atrophic/old (50.9%). Active lesions typically had increased dermal thickness in 66.6% of cases, while atrophic lesions often showed decreased dermal thickness (78.5%), with significant differences (p<0.05). Dermal echogenicity decreased in 40.7% of active lesions but remained largely unchanged in atrophic lesions (82.1%) (p<0.05). Subcutaneous tissue thickness significantly decreased in atrophic lesions (78.5%) and increased in 59.2% of active lesions, with a significant difference (p = 0.002). Subcutaneous tissue echogenicity increased in 44.4% of active lesions and remained mostly unchanged in atrophic lesions (67.8%). Importantly, a considerable proportion of lesions diagnosed as active through physical examination were actually inactive on HFUS evaluation (55.6%), while a significant portion of lesions categorized as atrophic on physical examination displayed areas of inactivity upon ultrasonographic assessment (35.7%). These findings highlight HFUS's potential as a valuable diagnostic tool and reveal discordances between clinical and HFUS staging. Conclusion: Ultrasonography offers an objective LS lesion evaluation, especially in pediatrics.