High-Frequency Ultrasound Assessment of Skin and Oral Mucosa in Metabolic Syndrome Patients—A Cross-Sectional Study

Abstract

Background: Exogenous factors (such as sun exposure, smoking habits, and diet) and endogenous (inflammatory status, general diseases) have a direct influence on skin and soft tissue characteristics. The study’s objective was to assess the impact of metabolic syndrome (MS) on characteristics of skin layers in sun-exposed and non-exposed maxillofacial tissues evaluated by high-frequency ultrasound (HFU), as a potential diagnosis and monitoring tool for the aging process. Material and methods: The present study included 102 subjects (24 with MS; 78 without MS). Anthropometric parameters and disease history were recorded, and blood samples were harvested in order to assess biochemical parameters of MS. Sun-exposed skin (zygomatic region) and non-exposed oral mucosa of the lower lip were assessed using HFU (DUB® cutis, Taberna Pro Medicum) with a 22 MHz probe. Results: Patients with cardiac disease had significantly lower values for epidermis density (p = 0.002). Gender was independently linked to the aged dermis depth (p < 0.001), aged dermis no. of px (pixels) (p < 0.001), dermis depth (p < 0.001), dermis no. of px (p < 0.001), and subcutaneous tissue density (p < 0.001). Patients with MS had thinner epidermis (p = 0.008) and thinner aged dermis (p = 0.037) when compared to non-MS subjects. Conclusion: Patients with MS had thinner epidermis and a lower epidermis number of pixels in sun-exposed skin. Women had lower epidermis density and thicker dermis in sun-exposed skin. Our study showed that HFU, as a non-invasive investigation approach, is useful to diagnose and monitor the aging process in skin and oral mucosa, correlated with skin phenotype pathological conditions.

In Situ Monitoring and Assessment of Ischemic Skin Flap by High-Frequency Ultrasound and Quantitative Parameters

“…This result is consistent with that of histological sections acquired from skin flap tissues excised on day 7 post-surgery, as given in Figure 13 , where the thickness of skin flap of different parts is estimated to be 3.17, 2.64, and 2.01 mm accordingly. Dehydration and collagen denaturation in the dermis of skin flap in accordance with the progress of necrosis may lead to the higher density of collagen fibers and the shrinkage of the extracellular matrix (ECM) [ 17 ], as can be seen in Figure 13 . Moreover, immune cells may be observed in the middle part of skin flap, as marked by the yellow arrows in Figure 13 , and correspond to more inflammatory response than the tissues of other regions.…”

“…It has been shown that 50 MHz high-frequency ultrasound (HFUS) imaging has a promising image resolution of up to 40 μm, capable of differentiating layers of tissue structures, including forearm, cheek, eye corner [ 13 ]. HFUS has also demonstrated the ability to diagnose inflammation responses [ 14 , 15 ] as considered for providing better treatment and care for an increase in skin flap survival as well as to characterize the skin tissue properties and severity of the cutaneous diseases in situ [ 16 , 17 ].…”