title: Sonography of acne vulgaris.
abstract: OBJECTIVE
  The purpose of this study was to assess the sonographic morphology of the clinical and subclinical pathology of facial acne vulgaris.
  
  
  METHODS
  We studied patients with facial acne vulgaris diagnosed by certified dermatologists, and using a standardized protocol for sonographic examinations, we sequentially described the sonographic pathomorphologic characteristics. Lesions of particular interest to the referring clinician were also analyzed separately. Additionally, acne involvement was staged clinically and sonographically (SOS-Acne) using morphologic definitions of the relevant lesions and predefined scoring systems for gradation of the severity of acne lesions.
  
  
  RESULTS
  A total of 245 acne lesions in 20 consecutive patients were studied. Sonographic abnormalities consisted of pseudocysts, folliculitis, fistulas, and calcinosis. Most conditions were subclinical and mostly due to lesion extensions deep into the dermis and hypodermis (52% of pseudocysts and 68% of fistulas). The statistical concordance between acne severity scores assigned by two separate clinicians was strong (κ = 0.8020), but the corresponding sonographic scores generally showed more severe and clinically occult involvement.
  
  
  CONCLUSIONS
  Facial acne vulgaris often involves deeper tissues, beyond the reach of the spatially restricted clinical examination; these subclinical conditions can be detected and defined with sonography. Additionally, acne vulgaris is amenable to sonographic scoring.
authors.affiliation: Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Lo Fontecilla 201, of 734, Las Condes, Santiago, Chile. xworts@yahoo.com.
authors.forename: Ximena
authors.initials: X
authors.lastname: Wortsman
authors.forename: Pedro
authors.initials: P
authors.lastname: Claveria
authors.forename: Fernando
authors.initials: F
authors.lastname: Valenzuela
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Molina
authors.forename: Jacobo
authors.initials: J
authors.lastname: Wortsman
mesh_terms: D000152:Acne Vulgaris / Q000000981:diagnostic imaging*; D000465:Algorithms; D005148:Facial Dermatoses / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012867:Skin / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D055815:Young Adult
keywords: acne; acne scoring; acne sonography; acne ultrasound; acne vulgaris; dermatologic sonography; skin sonography; skin ultrasound; superficial structures