title: Non-invasive Imaging of Localised Scleroderma for Assessment of Skin Blood Flow and Structure.
abstract: Extensive morphoea causes major morbidity, disability and disfigurement; pathophysiology is poorly understood. The aim of this study was to investigate, with non-invasive imaging, the relationship between localised abnormalities of skin structure and perfusion, which characterise morphoea. Thirty-two patients with morphoea underwent imaging at affected and unaffected sites. Skin thickness was imaged with optical coherence tomography (OCT) and high-frequency ultrasound (HFUS). Perfusion was imaged with dual-wavelength laser Doppler imaging (LDI) and thermography. Epidermal thickness showed a small increase from affected to unaffected site (OCT, active and inactive plaques [p = 0.005 and p = 0.004], HFUS active plaques only [p = 0.03]). Deeper perfusion was higher within affected than unaffected sites (LDI p < 0.001, thermography p < 0.0001, active and inactive plaques). Epidermal thickness was inversely related to superficial (but not deeper) perfusion. This novel study of OCT, HFUS, LDI and thermography confirms loss of epidermal thickness and increased deeper perfusion in morphea plaques.
authors.affiliation: Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, M6 8HD Salford, United Kingdom. andrea.murray@manchester.ac.uk.
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Murray
authors.forename: Tonia L
authors.initials: TL
authors.lastname: Moore
authors.forename: Joanne B
authors.initials: JB
authors.lastname: Manning
authors.forename: Graham
authors.initials: G
authors.lastname: Dinsdale
authors.forename: Jack
authors.initials: J
authors.lastname: Wilkinson
authors.forename: Monica
authors.initials: M
authors.lastname: Bhushan
authors.forename: Christopher E M
authors.initials: CE
authors.lastname: Griffiths
authors.forename: Ariane L
authors.initials: AL
authors.lastname: Herrick
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D012039:Regional Blood Flow; D012594:Scleroderma, Localized / Q000000981:diagnostic imaging* / Q000473:pathology; D012867:Skin / Q000098:blood supply* / Q000473:pathology; D013817:Thermography; D041623:Tomography, Optical Coherence; D014463:Ultrasonography