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2000
Volume 20, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
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Abstract

Background

Although clinical assessment has historically been the primary method used for diagnosing and staging pediatric localized scleroderma (LS), high-frequency ultrasonography (HFUS) is being investigated as a more accurate method for evaluating lesions.

Objectives

This study aimed to assess, compare dermal and subcutaneous tissue characteristics and 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.

This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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2024-01-01
2025-07-09
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  • Article Type:
    Research Article
Keyword(s): Childhood; Dermis; Lesion staging; Localized scleroderma; Subcutaneous tissue; Ultrasound
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