Ultrasonography patterns of atopic dermatitis in children

Abstract

Background: Atopic dermatitis (AD) is one of the most common allergic diseases in children. The aim of the study was to evaluate the ultrasound picture of lesional and non-lesional skin in children with AD. Materials and Methods: The study included a group of children with AD and a control group. Inclusion criteria were as follows: age 0-8 years and clinical diagnosis of AD. An ultrasound scanner with a 75 MHz transducer probe was used to produce B-mode skin images in lesions and non-lesional skin. The thickness and the echogenicity of epidermis, dermis, and subepidermal low-echogenic band (SLEB) were measured, and the ratio coefficient per body site was calculated. Results: Ultrasonography of non-lesional skin in children with AD showed uneven epidermis contour, a tendency to increased epidermis and decreased dermis thickness, and the SLEB was observed in 77% of cases. In lesions, there was an increased thickness and a decreased echogenicity of epidermis and dermis, and epidermis had irregular contours in most cases. The SLEB was in all lesions, showing greater thickness and lower echogenicity compared with non-lesional skin. Conclusion: HF-USG of the skin allows visualizing the epidermal barrier disruption and inflammation in dermis in children with AD on the entire surface of the skin.

High‐frequency ultrasound as a scientific tool for skin imaging analysis

“…Quantitative assessment of the total dermal thickness 6,38,39,45,55–61 or of the layers of the dermis, 4,31–33,35,40,42–44,48,51,62–64 epidermis, appendages 65 or subcutaneous tissue 48 is widely discussed in the literature.…”

“…In dermatology, this parameter is used to evaluate the therapeutic efficacy of various treatments in conditions such as psoriasis, 9,55,66 localized scleroderma, 67 systemic sclerosis, 4,42 hidradenitis suppurativa 10 and atopic dermatitis 64 . In addition, measurements of the skin lesion area, diameter and dimensions are also used in the diagnosis, characterization and evaluation of skin disease treatments 61,65,68–72 …”

“…The pathological processes that occur in the epidermis, dermis and subcutaneous tissue may change the echogenicity of these layers 68 . Similar to thickness measurement, echogenicity is a very interesting way to assess skin lesions in various conditions such as psoriasis, 75 atopic dermatitis, 41,64,68 localized scleroderma, 67,76 gynoid lipodystrophy (cellulite) 77 and other hypersensitivity reactions 61 . When compared to normal skin, sonograms usually show an irregular superficial hypoechoic band in the dermis during an acute inflammatory process 9,22,41,61,68 …”

“…Potential methods to determine the existence and quantify the severity, echogenicity and thickness of SLEB in the dermis layer have been discussed 33,34,36,56,60,78 . In general, all SLEB quantification methods are related to thickness, 34,41,56,58,60,64,81 raw values of echogenicity or relative echogenicity 34,57,58,64,79,81 …”

First clinical experience with a novel optical-ultrasound imaging device on various skin pathologies

“…The copyright holder for this preprint this version posted July 2, 2021. ; https://doi.org/10.1101/2021.06.28.21259325 doi: medRxiv preprint -12-thickness of a subepidermal low echogenic band (SLEB) on their skin ultrasound images. 10,33 A case of atopic dermatitis is presented on Figures 17-18. Clinically dry skin, mild erythema with erosions and signs of lichenification are visible.…”