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June 1996

The Use of High-Frequency Ultrasound as a Method of Assessing the Severity of a Plaque of Psoriasis

Author Affiliations

From the Division of Dermatology, Department of Medicine (Drs Gupta and Sauder), the Department of Imaging Research, Sunnybrook Health Science Center (Drs Turnbull and Foster and Ms Harasiewicz), the Division of Medical Physics, Toronto Sunnybrook Regional Cancer Center (Drs Turnbull and Foster and Ms Harasiewicz), and the Department of Medical Biophysics (Dr Turnbull), University of Toronto, Toronto, Ontario, and the Departments of Pathology (Dr Shum) and Statistics (Ms Watteel), University of Western Ontario, London. Dr Turnbull is now with the Skirball Institute of Biomolecular Medicine and the Department of Radiology, New York University Medical Center, New York.

Arch Dermatol. 1996;132(6):658-662. doi:10.1001/archderm.1996.03890300076011

Background and Design:  Ultrasound imaging, while initially developed to visualize internal organs, is now being applied to image the skin. In this preliminary study, we used a high-frequency, 40-MHz ultrasound imaging system to provide high-resolution images in psoriasis and examined the relationship between clinical and ultrasound ratings in plaque-type psoriasis. The ultrasound image of a psoriatic plaque demonstrates a superficial echogenic band (band A), followed by a nonchogenic band (band B), and a deeper echogenic band (band C).

Results:  In psoriatic plaques (N=145), the severity of the psoriasis as assessed according to the degree of scaling, erythema, and thickness (SET score) correlated best with the width of band B (P<.001, r=0.86) and less well with the width of bands A (P<.001, r=0.59) and C (P<.001, r=0.44). For the treated psoriatic plaques (n=64), for which paired readings were available before and after therapy, changes in the SET scores correlated best with the change in the width of band B (P<.001, r=0.96) and less well with the change in the width of bands A (P<.001, r=0.61) and C (P<.001, r=0.45). Ultrasound analyses and clinical evaluation were performed by independent raters.

Conclusions:  The data suggest that high-frequency ultrasound imaging may prove to be a noninvasive technique that can be used as an adjunct to the clinical evaluation of the lesional severity of psoriatic plaques.(Arch Dermatol. 1996;132:658-662)

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