Seemingly healthy skin in atopic dermatitis: observations with the use of high-frequency ultrasonography, preliminary...

Atopic dermatitis (AD) is a chronic, relapsing skin disorder which is strictly determined by the epidermal barrier function. In previous studies, there is conclusive evidence that normal-looking, nonlesional skin presents meaningful barrier function defect and a sub-clinical eczematous skin reaction.

The authors intended to visualize nonlesional AD skin with the use of high frequency ultrasonography to show that the normal-looking, nonlesional skin may present significant abnormalities in USG examination.

We have performed analysis with the use of high-frequency 20 MHz skin sonography in the cases of 15 AD patients of the Department of Dermatology, Medical University, Poznań, Poland. The clinical score has been evaluated on the basis of W-AZS index and EASI. The results were presented in the form of ultrasonographic images.

High frequency ultrasonography revealed an echopoor band within nonlesional skin of six (40%) examined AD patients and in all cases within skin lesions.

Our results indicate the significant role of skin ultrasonography in the complete clinical evaluation of patients with AD, which may serve as an element in selection of the most appropriate topical treatment. An echopoor band beneath the echo entry within nonlesional skin of some AD patients may reflect subclinical eczematous reaction and the readiness for the development of typical skin lesions. For this purpose, we suggest to name an intact skin in AD as seemingly healthy skin.