Search

Background: Although the cutaneous involvement of acromegaly has been recognized, the submacroscopical skin changes and the extent of skin thickening of patients remain unclear. Objectives: This study aimed at investigating the clinical cutaneous manifestations, dermoscopic features, and skin thickness revealed by high‐frequency ultrasound (HFUS) of acromegalic patients. Methods: A case‐control observational study was conducted. Patients with acromegaly and controls were prospectively included and received thorough cutaneous examinations to compare the macroscopical and dermoscopic features. The skin thickness measured by HFUS and its correlation with clinical data were also assessed. Results: Thirty‐seven and 26 patients from acromegalic and control group were included, respectively. Clinical skin manifestations were recorded in detail. Under dermoscopy, red structureless area (91.9% vs. 65.4%, p = 0.021), perifollicular orange halo (78.4% vs. 26.9%, p = 0.005), and follicular plug (70.3% vs. 3.9%, p = 0.001) in the facial area, and perifollicular pigmentation (91.9% vs. 23.1%), broom‐head hairs (83.8% vs. 3.9%), honeycomb‐like pigmentation (97.3% vs. 38.46%), widened dermatoglyphics (81.1% vs. 3.9%) at the extremities (p < 0.001) were more prevalent in acromegaly. The mean skin thickness was 4.10 ± 0.48 mm for acromegaly, and 3.55 ± 0.52 mm for controls (p < 0.001) but no correlation with disease duration, adenoma size, and hormone level was found in acromegaly. Conclusions: Submacroscopical skin changes under dermoscopy and skin thickness increase assessed by HFUS can provide clinicians with subtle evidences for early detection of acromegaly and objective parameters for accurate assessment of its skin involvement. [ABSTRACT FROM AUTHOR]

Background: The clinical manifestations of early mycosis fungoides (eMF) are non‐specific and similar to inflammatory skin diseases. High‐frequency ultrasonography (HF‐US) can show small structure of skin lesions and is helpful to provide information objectively. Materials and Methods: A case‐control study was designed in 62 patients with multiple erythemas and scales, including 18 eMF and 44 age‐matched patients with eczema (EC) or psoriasis vulgaris (PsV). The most significant lesions were collected by 50 MHz HF‐US. The assessment of ultrasound included epidermal morphology and thickness, infiltration depth, subepidermal low echogenic band (SLEB) boundary and thickness, internal echo, and number of linear acoustic shadows (LAS) behind the epidermis. The ultrasonic characteristics of eMF, EC, and PsV lesions were analyzed. Results: Epidermal thickness (P <.001, sensitivity 88.9%, specificity 75.0%) and SLEB thickness (P = 0.006, sensitivity 55.6%, specificity 90.9%) were useful for differential diagnosis of eMF and PsV/EC. When eMF was diagnosed by epidermal thickness < 0.2375 mm, the AUC was 0.845, which had the highest diagnostic efficacy among all ultrasound signs. In addition, compared with eMF and EC, the LAS number of PsV lesions was the highest and statistically significant. Conclusion: The results showed that HF‐US could provide some extra information in identification of eMF, EC, and PsV and has potential clinical value. [ABSTRACT FROM AUTHOR]

Background: Acne treatment may fail or cause undesirable side effects due to inaccurate evaluation. High‐frequency ultrasound (HFUS) can monitor systemic treatment in patients with moderate‐to‐severe acne vulgaris. Materials and methods: In this prospective study, consecutive patients with moderate‐to‐severe acne vulgaris were recruited. Patients were graded by a comprehensive clinical assessment before and after therapy. Simultaneous HFUS grading was independently evaluated according to the sonographic scoring system for acne (SSSA). Clinical and HFUS grades were compared through kappa analysis. Results: A total of 70 patients were enrolled. At baseline, 36 (51.4%) and 34 (48.6%) patients were graded as moderate and severe, respectively, through clinical assessment. However, 27 patients (38.6%) scored SSSA‐Grade II and 43 (61.4%) scored SSSA‐Grade III in the HFUS grading. Sixty‐one patients (87.1%) were in the consistent category as per clinical assessment and HFUS grades, with Kappa1 = 0.745, whereas higher HFUS grades were observed in nine patients. By the end of the observation, 65 of all patients (92.9%) showed significant improvement and 5 (7.1%) showed no apparent improvement after the treatment. According to the clinical assessment, 14, 52, and 4 patients were graded as mild, moderate, and severe, respectively. On the other hand, 11, 51, and 8 patients had SSSA‐Grade I, II, and III, respectively. Of all patients, 63 (90.0%) had consistent evaluation results, with Kappa2 = 0.762, whereas the remaining seven patients had an HFUS grade higher than the clinical. Conclusion: HFUS is a useful tool for dermatologists to monitor the treatment of moderate and severe acne vulgaris. [ABSTRACT FROM AUTHOR]

Background: Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Occasionally, it may have an appearance similar to that of some benign pigmented skin lesions. Therefore, additional information is needed to differentiate these lesions. Materials and Methods: A diagnostic accuracy study was performed from February 2018 to April 2019. All lesions underwent ultrasound examination with 50 and 20 MHz probes. The high‐frequency ultrasound (HFUS) images were evaluated independently by 2 experienced doctors for the presence of predefined features, including the depth, shape, margin, anechoic area, hyperechoic spots, epidermal interrupted echo, mushroom sign, flat‐bottom sign, and superficial hyperechoic focus (SHEF). Results: A total of 54 BCCs, 51 melanocytic nevi and 55 seborrheic keratoses (SK), were included. BCCs often involved the subcutaneous tissue (11/54, 20.4%; P <.001) and had an irregular shape (26/54, 48.1%; P <.001) and ill‐defined borders (26/54, 48.1%; P <.001), while most benign pigmented lesions had a regular shape (101/106, 95.3%; P <.001) and well‐defined borders (95/106, 89.6%; P <.001). BCCs occasionally showed anechoic areas (10/54, 18.5%; P <.001) and epidermal interrupted echo (18/54, 33.3%; P <.001). Moreover, hyperechoic spots could be found in BCCs (43/54, 79.6%), nevi (27/51, 52.9%), and SK (30, 54.5%) (P =.001), with mean number of 7.3, 5.5, and 8.0, respectively. The mushroom signs were all present in melanocytic nevi (18/51, 35.3%), while the flat‐bottom sign (43/55, 78.2%; P <.001) and SHEF (40/55, 72.7%; P <.001) presented mainly in SKs. Conclusions: Based on the typical features, HFUS could improve the accuracy of BCC identification and should be considered when dermatologists are unsure about the lesion type. [ABSTRACT FROM AUTHOR]