High frequency ultrasound can detect improvement of lesions in juvenile localized scleroderma. Issue 5 (September 2014)

• Record Type: Journal Article
• Authors: Porta, Francesco; Kaloudi, Olga; Garzitto, Alice; Prignano, Francesca; Nacci, Francesca; Falcini, Fernanda; Matucci Cerinic, Marco
• Is Part Of: Modern rheumatology. Volume 24:Issue 5(2014)
• Page Start: 869
• Page End: 873
• Publication Date: 2014-09
• Subjects: Rheumatology -- Periodicals; 616.723005
• DOI: 10.3109/14397595.2013.844301
• Languages: English
• ISSNs: 1439-7595

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background</italic>. Juvenile Localized Scleroderma (JLS) causes functional disabilities and cosmetic deformities. Evaluation and follow-up of lesions are mandatory to understand the disease evolution. The objective of this study is to evaluate the usefulness of skin ultrasonography (US) in monitoring the response to treatment in JLS.</p> <p> <italic>Methods.</italic> Ten patients (age: 101, 7 ± 66, 2 months; 7 M, 3 F) affected by juvenile onset LS underwent sequential US exams (at baseline and after 6 months). Skin thickness was measured by using high-frequency US (18 MHz). All patients were evaluated both clinically (modified Rodnan Skin Score, mRSS) and by US (dermal thickness) at baseline and at 6 months. At baseline, 6/10 patients received 3 pulses of corticosteroids (solumedrol 30 mg/kg/day for 3 consecutive days, then oral steroids (1mg/kg), and methotrexate s.c. (15 mg/mq/week). After 6 months, 1/6 was switched to mycophenolate mofetil (25 mg/kg/day) due to inefficacy of MTX; 4/10 did not receive any further therapy.</p> <p> <italic>Results</italic>. US showed a thicker dermis and a thinned hypodermis in the lesional skin areas in respect to the healthy ones (<italic>p < </italic>0.05). After treatment, in seven patients a clinical improvement (decrease of mRSS) was found. In six of these patients, US showed a decrease of dermal thickness showing a correlation with clinical data. Three patients who did not receive drugs showed unmodified images and clinical findings.</p> <p> <italic>Conclusion.</italic> US can help the assessment of skin and hypodermis in JLS and can detect an improvement of the lesions.</p> </abstract>