Affiliation:
1. Department of Pediatric Rheumatology, University of Health Sciences, Ümraniye Training and Research Hospital, Istanbul, Turkey
Abstract
Background:
Although clinical assessment has historically been the primary method used for pediatric localized sclerosis (LS) diagnosis and staging, highfrequency
ultrasonography (HFUS) is being investigated as a more accurate evaluation method for lesion.
Objectives:
This study aimed to assess, compare dermal and subcutaneous tissue characteristics and enhance enhance lesion staging in pediatric LS patients
using HFUS.
Methods:
Twenty two LS patients were cross-sectionally evaluated with B-mode ultrasonography. Lesions were clinically staged, and dermal and
subcutaneous tissue characteristics were compared with healthy tissue using HFUS.
Results:
Among 55 lesions, 27 were active/new (49.1%), and 28 were atrophic/old (50.9%). Active lesions typically had increased dermal thickness in
66.6% of cases, while atrophic lesions often showed decreased dermal thickness (78.5%), with significant differences (p<0.05). Dermal
echogenicity decreased in 40.7% of active lesions but remained largely unchanged in atrophic lesions (82.1%) (p<0.05). Subcutaneous tissue
thickness significantly decreased in atrophic lesions (78.5%) and increased in 59.2% of active lesions, with a significant difference (p = 0.002).
Subcutaneous tissue echogenicity increased in 44.4% of active lesions and remained mostly unchanged in atrophic lesions (67.8%). Importantly, a
considerable proportion of lesions diagnosed as active through physical examination were actually inactive on HFUS evaluation (55.6%), while a
significant portion of lesions categorized as atrophic on physical examination displayed areas of inactivity upon ultrasonographic assessment
(35.7%). These findings highlight HFUS's potential as a valuable diagnostic tool and reveal discordances between clinical and HFUS staging.
Conclusion:
Ultrasonography offers an objective LS lesion evaluation, especially in pediatrics.
Publisher
Bentham Science Publishers Ltd.