Ultrasound imaging of psoriatic skin: a noninvasive technique to evaluate treatment of psoriasis.
BACKGROUND
The aim of our study was to image psoriasis plaques by ultrasound to assess the changes in psoriasis and to measure and quantify them objectively.


METHODS
Thirty-one psoriasis plaques were studied in 19 patients. Measurements of skin thickness were obtained with a high resolution B-mode echographic system.


RESULTS
Some changes were seen in psoriatic skin. A new structural element was observed: a wide subepidermal nonechogenic band. The other changes were a decrease in dermal echoes that were less intense and less dense, and an increase in the epidermal and dermal skin thicknesses. The skin thickness was increased in all psoriasis plaques as compared to apparently normal skin (P < 0.001). The average increase was 67% for whole skin and 200% for epidermis.


CONCLUSIONS
Ultrasound imaging of psoriatic skin allowed the identification of different skin changes induced by psoriasis, and particularly, the differentiation between epidermal and dermal alterations. We presume that epidermal thickness reflects epidermal proliferation and desquamation, and the increase in the dermal and whole skin thickness reflects infiltration. We feel that ultrasound imaging of psoriatic skin is a quantitative method that is as easy and noninvasive as the psoriasis area and severity index (PASI). It could be used for following up patients with psoriasis and could achieve widespread use, especially in research protocols.
Vaillant
L
L
Department of Dermatology, Unity INSERM U 316, CHU Tours, France.
Berson
M
M
Machet
L
L
Callens
A
A
Pourcelot
L
L
Lorette
G
G
D000328:Adult; D000368:Aged; D002455:Cell Division; D016572:Cyclosporine / Q000627:therapeutic use; D004338:Drug Combinations; D004817:Epidermis / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005944:Glucosamine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011701:PUVA Therapy; D011565:Psoriasis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D012867:Skin / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D012460:Sulfasalazine / Q000627:therapeutic use; D014463:Ultrasonography
D004338:Drug Combinations; C028423:Salazopyrine; D012460:Sulfasalazine; D016572:Cyclosporine; D005944:Glucosamine; D008727:Methotrexate