Superb microvascular imaging for evaluating the activity of juvenile localised scleroderma: a preliminary study

Area of Science:

• Dermatology
• Medical Imaging
• Pediatrics

Background:

• Juvenile localised scleroderma (JLS) is a chronic autoimmune condition affecting the skin and underlying tissues.
• Assessing JLS activity and severity often relies on subjective clinical evaluations.
• Microvascular changes are a hallmark of active scleroderma lesions.

Purpose of the Study:

• To investigate microvascular alterations in JLS lesions using Superb Microvascular Imaging (SMI).
• To evaluate the utility of SMI in quantitatively assessing JLS disease activity and severity.
• To correlate SMI findings with established clinical assessment tools for JLS.

Main Methods:

• A prospective study included 16 children diagnosed with JLS.
• Lesions were assessed using Localised Scleroderma Cutaneous Assessment Tools (LoSAI, LoSDI).
• Ultrasound with SMI was employed to measure skin thickness and calculate the vascular index (VI) in lesions and healthy skin, correlating VI with clinical scores.

Main Results:

• SMI revealed significantly higher vascular index (VI) in active JLS lesions compared to inactive lesions and healthy skin (p<0.001).
• VI in inactive lesions was also significantly different from healthy skin (p=0.011).
• The difference in VI between active lesions and healthy skin showed a strong positive correlation with LoSAI (r=0.625, p=0.001) and total scores (r=0.842, p<0.001).

Conclusions:

• SMI is a valuable, non-invasive tool for quantitatively assessing microvascular blood flow in JLS lesions.
• SMI findings correlate well with clinical disease activity and severity, aiding in objective evaluation.
• This technique can provide crucial information to guide treatment decisions for JLS.