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Localized scleroderma (morphoea): thickness of sclerotic plaques as measured by 15 MHz pulsed ultrasound
Abstract:
The thickness of morphoea plaques was measured by A-mode ultrasound and compared to regional control measurements in the same individuals. The thickness of morphoea plaques was increased by 18-310% in 17 patients with one or a few morphoea plaques (p less than 0.01), and by 13-145% in 6 patients with generalized morphoea (p less than 0.05). The increase in thickness of morphoea plaques was local confined to the plaques. Ipsilateral and contralateral control measurements were not different, and measurements in a standard region (forearm) were not different from those in a group of healthy controls matched for sex and age. Plaques of clinically 'advanced' scleroderma were more thickened (p less than 0.01) than plaques of 'slight' scleroderma. The relative increase in thickness was larger (p less than 0.01) in skin with a habitual thickness of 0.8-1.1 mm. The habitual skin thickness on the extremities (mean 1.0 mm) was less (p less than 0.01) than on the trunk (mean 1.5 mm), and, consistently, plaques with 'advanced' scleroderma were more frequent (p less than 0.05) on the extremities. Ultrasound measurement of skin thickness was accurate with SD form 0.05-0.09 mm and coefficients of variation from 3-7% in reproducibility studies of typical morphoea plaques as well as normal appearing skin.
Insights
A-mode ultrasound accurately measured increased morphoea plaque thickness in patients. Advanced scleroderma plaques were significantly thicker, especially on extremities with thinner habitual skin.
Area of Science:
- Dermatology
- Medical Imaging
- Rheumatology
Background:
- Morphea, a localized scleroderma, involves skin thickening.
- Accurate measurement of skin thickness is crucial for assessing disease severity.
Purpose of the Study:
- To evaluate the diagnostic accuracy of A-mode ultrasound for measuring morphoea plaque thickness.
- To compare plaque thickness with disease severity and patient characteristics.
Main Methods:
- A-mode ultrasound was used to measure the thickness of morphoea plaques.
- Measurements were compared to regional control sites in the same individuals and healthy controls.
- Plaque thickness was correlated with clinical classification ('slight' vs. 'advanced' scleroderma) and habitual skin thickness.
Main Results:
- Morphea plaques showed significant thickness increases (18-310% in localized, 13-145% in generalized morphea).
- Advanced scleroderma plaques were significantly thicker than slight scleroderma plaques (p < 0.01).
- Ultrasound measurements demonstrated high accuracy and reproducibility (SD 0.05-0.09 mm, CV 3-7%).
Conclusions:
- A-mode ultrasound is a reliable method for quantifying morphoea plaque thickness.
- Skin thickness measured by ultrasound correlates with disease severity.
- Findings support ultrasound's utility in morphea assessment and research.