title: Reduced skin thickness: a new minor diagnostic criterion for the classical and hypermobility types of Ehlers-Danlos syndrome.
abstract: BACKGROUND
  The diagnosis of Ehlers-Danlos syndrome (EDS) is mainly based on clinical criteria, although in some instances a sound molecular diagnosis is available. Clinical signs can be divided into two categories: one with high diagnostic specificity and the other with low specificity. Despite the fact that reduced skin thickness is one of the dermatological features in patients with EDS, this issue has not been analysed in greater detail.
  
  
  OBJECTIVE
  To determine skin thickness in patients with the classical and the hypermobility types of EDS.
  
  
  METHODS
  In 21 patients with classical type of EDS and in nine patients with hypermobility type of EDS, skin thickness was analysed at different body sites by cross-sectional b-mode scans obtained with a 20-MHz ultrasound system.
  
  
  RESULTS
  We found a significant decrease in skin thickness in both types of EDS, which was highest at the chest and at the distal part of the lower leg.
  
  
  CONCLUSIONS
  We propose that the reduced thickness of the dermis as determined by high-resolution 20-MHz ultrasound can be used as a new minor criterion in the diagnosis of the classical and the hypermobility types of EDS.
authors: Department of Dermatology, University of Lübeck, 23538 Lübeck, Germany.
authors: C
authors: C
authors: Eisenbeiss
authors: A
authors: A
authors: Martinez
authors: M
authors: M
authors: Hagedorn-Greiwe
authors: D P
authors: DP
authors: Reinhardt
authors: B
authors: B
authors: Bätge
authors: J
authors: J
authors: Brinckmann
mesh_terms: D004535:Ehlers-Danlos Syndrome / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007866:Leg; D012867:Skin / Q000000981:diagnostic imaging* / Q000473:pathology; D013909:Thorax; D014463:Ultrasonography