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Hobayan CGP, Gray AN, Waters MF, Mager LA, Kobayashi S, Essien EW, Ulman CA, Kaffenberger BH. Diagnostic accuracy of high-frequency ultrasound for cutaneous neoplasms: a narrative review of the literature. Arch Dermatol Res 2024; 316:419. [PMID: 38904763 PMCID: PMC11192820 DOI: 10.1007/s00403-024-03179-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/07/2024] [Accepted: 06/08/2024] [Indexed: 06/22/2024]
Abstract
High-frequency ultrasound has been used to visualize depth and vascularization of cutaneous neoplasms, but little has been synthesized as a review for a robust level of evidence about the diagnostic accuracy of high-frequency ultrasound in dermatology. A narrative review of the PubMed database was performed to establish the correlation between ultrasound findings and histopathologic/dermoscopic findings for cutaneous neoplasms. Articles were divided into the following four categories: melanocytic, keratinocytic/epidermal, appendageal, and soft tissue/neural neoplasms. Review of the literature revealed that ultrasound findings and histopathology findings were strongly correlated regarding the depth of a cutaneous neoplasm. Morphological characteristics were correlated primarily in soft tissue/neural neoplasms. Overall, there is a paucity of literature on the correlation between high-frequency ultrasound and histopathology of cutaneous neoplasms. Further studies are needed to investigate this correlation in various dermatologic conditions.
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Affiliation(s)
| | - Ashley N Gray
- Department of Dermatology, The Ohio State University, 540 Officecenter Place, Suite 240, Columbus, OH, 43230, USA
| | - Margo F Waters
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Layna A Mager
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sonja Kobayashi
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ellen W Essien
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Catherine A Ulman
- Department of Dermatology, The Ohio State University, 540 Officecenter Place, Suite 240, Columbus, OH, 43230, USA
| | - Benjamin H Kaffenberger
- Department of Dermatology, The Ohio State University, 540 Officecenter Place, Suite 240, Columbus, OH, 43230, USA.
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2
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Yu N, Huang K, Li Y, Jiang Z, Liu S, Liu Y, Liu X, Chen Z, He R, Wei T. The utility of high-frequency 18 MHz ultrasonography for preoperative evaluation of acral melanoma thickness in Chinese patients. Front Oncol 2023; 13:1185389. [PMID: 37869100 PMCID: PMC10585136 DOI: 10.3389/fonc.2023.1185389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/15/2023] [Indexed: 10/24/2023] Open
Abstract
Background Despite the increasing use of preoperative ultrasound evaluation for melanoma, there is limited research on the use of this technique for Acral Melanoma (AM). Methods This retrospective study analyzed the electronic medical records of patients who underwent preoperative evaluation for cutaneous melanoma maximum thickness using an 18 MHz probe and histopathological examination between December 2017 and March 2021 at the Department of Dermatology in Xiangya Hospital, Central South University. Results A total of 105 patients were included in the study. The mean tumor thickness was 3.9 mm (s.d., 2.3), with 63% of the specimens showing ulceration and 44 patients showing lymph node metastasis. The results showed a good correlation between the high-frequency ultrasonography (HFUS) and histopathological thickness measurements, with a Spearman's correlation coefficient of 0.83 [(95% CI 0.73-0.90) (P < 0.001)]. The positive predictive value (PPV) of sonography in identifying tumor thickness was also found to be high. Conclusion Our study suggests that high-frequency 18 MHz ultrasonography is an effective tool for the preoperative evaluation of AM thickness. The HFUS measurements correlated well with the histopathological thickness measurements, making it a valuable and reliable method for clinicians to assess the thickness of melanoma lesions preoperatively.
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Affiliation(s)
- Nianzhou Yu
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Kai Huang
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yixin Li
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zixi Jiang
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Siliang Liu
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuancheng Liu
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaowan Liu
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zeyu Chen
- State Key Laboratory of High Performance Complex Manufacturing, College of Mechanical and Electrical Engineering, Central South University, Changsha, China
| | - Renliang He
- Department of Dermatologic Surgery, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Tianhong Wei
- Department of Ultrasound, Xiangya Hospital, Central South University, Changsha, Hunan, China
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3
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Dini V, Iannone M, Michelucci A, Manzo Margiotta F, Granieri G, Salvia G, Oranges T, Janowska A, Morganti R, Romanelli M. Ultra-High Frequency UltraSound (UHFUS) Assessment of Barrier Function in Moderate-to-Severe Atopic Dermatitis during Dupilumab Treatment. Diagnostics (Basel) 2023; 13:2721. [PMID: 37685259 PMCID: PMC10487092 DOI: 10.3390/diagnostics13172721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/11/2023] [Accepted: 08/13/2023] [Indexed: 09/10/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic multifactorial inflammatory disease characterized by intense itching and inflammatory eczematous lesions. Biological disease-modifying drugs, such as dupilumab are recommended for patients with moderate-to-severe AD, refractory to systemic immunosuppressive therapies. Disease monitoring is performed by clinical scores. Since 1970, however, the use of ultrasound and particularly high-frequency ultrasound (HFUS), has identified alterations in dermal echogenicity, called the subepidermal low-echogenic band (SLEB), that correlates with disease severity and response to treatment. We enrolled 18 patients with moderate-to-severe AD, divided into two groups: twelve patients in the dupilumab treatment (Group A) and six patients in standard treatment, from February 2019 to November 2019. We performed ultra-high frequency ultrasound (UHFUS) evaluation of lesional and non-lesional skin, focusing on SLEB average thicknesses measurement, epidermal thickness, and vascular signal in correlation with objective disease scores (EASI, IGA), patient's reported scores (Sleep Quality NRS and Itch NRS), and TEWL and corneometry at baseline (T0), after 1 month (T1) and 2 months (T2). The SLEB average thickness measurement, vascular signal, and epidermal thickness showed a statistically significant reduction in lesional skin of the biological treatment group and no significant reduction in non-lesional skin in both groups. In the lesional skin of the standard treatment group, only epidermal thickness showed a statistically significant reduction. Our study demonstrates that SLEB measurement, vascular signals, and epidermal thickness could be used as objective parameters in monitoring the AD treatment response, while the presence of SLEB in non-lesional skin could be used as a marker of subclinical inflammation and could predict development of clinical lesions, suggesting a pro-active therapy. Further follow-up and research are needed to clarify the association of SLEB decrease/disappearance with a reduction of flares/prolongment of the disease remission time.
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Affiliation(s)
- Valentina Dini
- Department of Dermatology, University of Pisa, 56126 Pisa, Italy; (V.D.); (M.I.); (F.M.M.); (G.G.); (G.S.); (A.J.); (M.R.)
| | - Michela Iannone
- Department of Dermatology, University of Pisa, 56126 Pisa, Italy; (V.D.); (M.I.); (F.M.M.); (G.G.); (G.S.); (A.J.); (M.R.)
| | - Alessandra Michelucci
- Department of Dermatology, University of Pisa, 56126 Pisa, Italy; (V.D.); (M.I.); (F.M.M.); (G.G.); (G.S.); (A.J.); (M.R.)
| | - Flavia Manzo Margiotta
- Department of Dermatology, University of Pisa, 56126 Pisa, Italy; (V.D.); (M.I.); (F.M.M.); (G.G.); (G.S.); (A.J.); (M.R.)
| | - Giammarco Granieri
- Department of Dermatology, University of Pisa, 56126 Pisa, Italy; (V.D.); (M.I.); (F.M.M.); (G.G.); (G.S.); (A.J.); (M.R.)
| | - Giorgia Salvia
- Department of Dermatology, University of Pisa, 56126 Pisa, Italy; (V.D.); (M.I.); (F.M.M.); (G.G.); (G.S.); (A.J.); (M.R.)
| | - Teresa Oranges
- Unit of Dermatology, Department of Pediatrics, IRCCS Meyer Children’s Hospital, 50139 Florence, Italy;
| | - Agata Janowska
- Department of Dermatology, University of Pisa, 56126 Pisa, Italy; (V.D.); (M.I.); (F.M.M.); (G.G.); (G.S.); (A.J.); (M.R.)
| | - Riccardo Morganti
- Statistical Support to Clinical Trials Department, University of Pisa, 56126 Pisa, Italy;
| | - Marco Romanelli
- Department of Dermatology, University of Pisa, 56126 Pisa, Italy; (V.D.); (M.I.); (F.M.M.); (G.G.); (G.S.); (A.J.); (M.R.)
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Cummins MR, Ong T, Ivanova J, Barrera JF, Wilczewski H, Soni H, Welch BM, Bunnell BE. Consensus Guidelines for Teledermatology: Scoping Review. JMIR DERMATOLOGY 2023; 6:e46121. [PMID: 37632944 PMCID: PMC10335147 DOI: 10.2196/46121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/05/2023] [Accepted: 04/23/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Consensus guidelines and recommendations play an important role in fostering quality, safety, and best practices, as they represent an expert interpretation of the biomedical literature and its application to practice. However, it is unclear whether the recent collective experience of implementing telemedicine and the concurrent growth in the evidence base for teledermatology have resulted in more robust guidance. OBJECTIVE The objective of this review was to describe the extent and nature of currently available guidance, defined as consensus guidelines and recommendations available for telemedicine in dermatology, with guidance defined as consensus or evidence-based guidelines, protocols, or recommendations. METHODS We conducted a single-reviewer scoping review of the literature to assess the extent and nature of available guidance, consensus guidelines, or recommendations related to teledermatology. We limited the review to published material in English since 2013, reflecting approximately the past 10 years. We conducted the review in November and December of the year 2022. RESULTS We identified 839 potentially eligible publications, with 9 additional records identified through organizational websites. A total of 15 publications met the inclusion and exclusion criteria. The guidelines focused on varied topics and populations about dermatology and skin diseases. However, the most frequent focus was general dermatology (8/15, 53%). Approximately half of the telemedicine guidance described in the publications was specific to dermatology practice in the context of the COVID-19 pandemic. The publications were largely published in or after the year 2020 (13/15, 87%). Geographical origin spanned several different nations, including Australia, the United States, European countries, and India. CONCLUSIONS We found an increase in COVID-19-specific teledermatology guidance during 2020, in addition to general teledermatology guidance during the period of the study. Primary sources of general teledermatology guidance reported in the biomedical literature are the University of Queensland's Centre for Online Health and Australasian College of Dermatologists E-Health Committee, and the American Telemedicine Association. There is strong evidence of international engagement and interest. Despite the recent increase in research reports related to telemedicine, there is a relative lack of new guidance based on COVID-19 lessons and innovations. There is a need to review recent evidence and update existing recommendations. Additionally, there is a need for guidance that addresses emerging technologies.
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Affiliation(s)
- Mollie R Cummins
- College of Nursing, University of Utah, Salt Lake City, UT, United States
- Department of Biomedical Informatics, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
- Doxy.me, Inc, Rochester, NY, United States
| | - Triton Ong
- Doxy.me, Inc, Rochester, NY, United States
| | | | - Janelle F Barrera
- Doxy.me, Inc, Rochester, NY, United States
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
| | | | - Hiral Soni
- Doxy.me, Inc, Rochester, NY, United States
| | - Brandon M Welch
- Doxy.me, Inc, Rochester, NY, United States
- Biomedical Informatics Center, Public Health and Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brian E Bunnell
- Doxy.me, Inc, Rochester, NY, United States
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
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Ghosh D, Salinas CM, Pallod S, Roberts J, Makin IRS, Yaron JR, Witte RS, Rege K. Temporal evaluation of efficacy and quality of tissue repair upon laser-activated sealing. Bioeng Transl Med 2023; 8:e10412. [PMID: 36925709 PMCID: PMC10013809 DOI: 10.1002/btm2.10412] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 11/11/2022] Open
Abstract
Injuries caused by surgical incisions or traumatic lacerations compromise the structural and functional integrity of skin. Immediate approximation and robust repair of skin are critical to minimize occurrences of dehiscence and infection that can lead to impaired healing and further complication. Light-activated skin sealing has emerged as an alternative to sutures, staples, and superficial adhesives, which do not integrate with tissues and are prone to scarring and infection. Here, we evaluate both shorter- and longer-term efficacy of tissue repair response following laser-activated sealing of full-thickness skin incisions in immunocompetent mice and compare them to the efficacy seen with sutures. Laser-activated sealants (LASEs) in which, indocyanine green was embedded within silk fibroin films, were used to form viscous pastes and applied over wound edges. A hand-held, near-infrared laser was applied over the incision, and conversion of the light energy to heat by the LASE facilitated rapid photothermal sealing of the wound in approximately 1 min. Tissue repair with LASEs was evaluated using functional recovery (transepidermal water loss), biomechanical recovery (tensile strength), tissue visualization (ultrasound [US] and photoacoustic imaging [PAI]), and histology, and compared with that seen in sutures. Our studies indicate that LASEs promoted earlier recovery of barrier and mechanical function of healed skin compared to suture-closed incisions. Visualization of sealed skin using US and PAI indicated integration of the LASE with the tissue. Histological analyses of LASE-sealed skin sections showed reduced neutrophil and increased proresolution macrophages on Days 2 and 7 postclosure of incisions, without an increase in scarring or fibrosis. Together, our studies show that simple fabrication and application methods combined with rapid sealing of wound edges with improved histological outcomes make LASE a promising alternative for management of incisional wounds and lacerations.
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Affiliation(s)
- Deepanjan Ghosh
- Biological Design Graduate Program, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
| | | | - Shubham Pallod
- Biological Design Graduate Program, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
| | - Jordan Roberts
- School of Life SciencesArizona State UniversityTempeArizonaUSA
| | | | - Jordan R. Yaron
- Biological Design Graduate Program, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
- Department of Chemical Engineering, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
| | - Russell S. Witte
- James C. Wyant College of Optical SciencesUniversity of ArizonaTucsonArizonaUSA
- Department of Medical ImagingUniversity of ArizonaTucsonArizonaUSA
| | - Kaushal Rege
- Biological Design Graduate Program, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
- Department of Chemical Engineering, School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeArizonaUSA
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6
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Chai K, Zhu R, Luo F, Shi Y, Liu M, Xiao Y, Xiao R. Updated Role of High-frequency Ultrasound in Assessing Dermatological Manifestations in Autoimmune Skin Diseases. Acta Derm Venereol 2022; 102:adv00765. [PMID: 36000997 PMCID: PMC9558316 DOI: 10.2340/actadv.v102.1969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Autoimmune skin diseases are a group of disorders that arise due to the dysregulated immune system attacking self-antigens, causing multiple tissue and organ lesions. With disease progression, the physical and psychological health of patients may be seriously damaged. High-frequency ultrasound is non-invasive, reproducible, and suitable for visualizing the fine structure of external organs. The usage of high-frequency ultrasound has increased in recent years in the auxiliary diagnosis and monitoring of various skin diseases; it serves as a promising tool for dermatological disease assessment. This review summarizes the characteristics of high-frequency ultrasound imaging in common autoimmune skin diseases, including systemic lupus erythematosus, scleroderma, psoriasis, dermatomyositis, and pemphigus/pemphigoid. The objective of this review is to provide new ideas and strategies for dermatologists to diagnose and track the prognosis of autoimmune skin diseases.
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Affiliation(s)
| | | | | | | | | | - Yangfan Xiao
- Department of Anesthesiology, The Second Xiangya Hospital of Central South University, Changsha, China.
| | - Rong Xiao
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China.
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Fractal Dimension Analysis of Melanocytic Nevi and Melanomas in Normal and Polarized Light-A Preliminary Report. LIFE (BASEL, SWITZERLAND) 2022; 12:life12071008. [PMID: 35888097 PMCID: PMC9318244 DOI: 10.3390/life12071008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 11/21/2022]
Abstract
Clinical diagnosis of pigmented lesions can be a challenge in everyday practice. Benign and dysplastic nevi and melanomas may have similar clinical presentations, but completely different prognoses. Fractal dimensions of shape and texture can describe the complexity of the pigmented lesion structure. This study aims to apply fractal dimension analysis to differentiate melanomas, dysplastic nevi, and benign nevi in polarized and non-polarized light. A total of 87 Eighty-four patients with 97 lesions were included in this study. All examined lesions were photographed under polarized and non-polarized light, surgically removed, and examined by a histopathologist to establish the correct diagnosis. The obtained images were then processed and analyzed. Area, perimeter, and fractal dimensions of shape and texture were calculated for all the lesions under polarized and non-polarized light. The fractal dimension of shape in polarized light enables differentiating melanomas, dysplastic nevi, and benign nevi. It also makes it possible to distinguish melanomas from benign and dysplastic nevi under non-polarized light. The fractal dimension of texture allows distinguishing melanomas from benign and dysplastic nevi under polarized light. All examined parameters of shape and texture can be used for developing an automatic computer-aided diagnosis system. Polarized light is superior to non-polarized light for imaging texture details.
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Crisan D, Wortsman X, Alfageme F, Catalano O, Badea A, Scharffetter-Kochanek K, Sindrilaru A, Crisan M. Ultraschall in der Dermatochirurgie: Enthüllen des Verborgenen für optimierte chirurgische Planung. J Dtsch Dermatol Ges 2022; 20:913-927. [PMID: 35881098 DOI: 10.1111/ddg.14781_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Diana Crisan
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Ulm, Deutschland
| | - Ximena Wortsman
- Klinik für Dermatologie, Institut für diagnostische Bildgebung und Erforschung der Haut und Weichteilgewebe, Medizinische Fakultät, Chile Universität, Santiago, Chile
| | - Fernando Alfageme
- Klinik für Dermatologie, Universitätsklinikum Puerta del Hierro, EFSUMB Dermatologisches Ultraschall-Lernzentrum, Majahonda, Madrid, Spanien
| | - Orlando Catalano
- Klinik für Radiologie, Diagnostisches Institut Varelli, Neapel, Italien
| | - Alexandru Badea
- Institut für Anatomie, Iuliu Hatieganu" Universität für Medizin und Pharmazie, Klausenburg, Rumänien
| | | | - Anca Sindrilaru
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Ulm, Deutschland
| | - Maria Crisan
- Klinik für Dermatologie, Abteilung Histologie, "Iuliu Hatieganu" Universität für Medizin und Pharmazie, Klausenburg, Rumänien
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9
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Crisan D, Wortsman X, Alfageme F, Catalano O, Badea A, Scharffetter-Kochanek K, Sindrilaru A, Crisan M. Ultrasonography in dermatologic surgery: revealing the unseen for improved surgical planning. J Dtsch Dermatol Ges 2022; 20:913-926. [PMID: 35616215 DOI: 10.1111/ddg.14781] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/02/2022] [Indexed: 11/28/2022]
Abstract
Ultrasonography (US) is a modern, in vivo imaging method, which is increasingly being used in dermatology as a complementary tool to clinical examination and dermoscopy. At higher frequencies (15 MHz and above), US is an established method for assessing benign and malignant skin lesions, locoregional staging, monitoring the therapeutic efficacy in various inflammatory skin conditions, and patient follow-up. One field, which may increasingly benefit from performant imaging techniques such as US is dermatologic surgery. Preoperative imaging of cutaneous tumors, inflammatory skin conditions (hidradenitis suppurativa, abscesses, etc.), or nail pathology provide dermatologic surgeons with relevant information for an optimal surgical planning, identifying potential complex aspects which might require interdisciplinary approaches, herein sparing unnecessary surgical interventions and increasing patients' compliance. In this review, we discuss the increasing significance of US in the field of dermatologic surgery, as well as the spectrum of cutaneous pathology where sonography can aid in the preoperative setting to provide a more precise, individualized surgical planning for better counseling to our patients and improved surgical results.
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Affiliation(s)
- Diana Crisan
- Department of Dermatology and Allergic Diseases, University Clinic Ulm, Germany
| | - Ximena Wortsman
- Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Fernando Alfageme
- Department of Dermatology, University Hospital Puerta del Hierro, EFSUMB Dermatologic Ultrasound Learning Center, Majahonda, Madrid, Spain
| | - Orlando Catalano
- Department of Radiology, Istituto Diagnostico Varelli, Naples, Italy
| | - Alexandru Badea
- Department of Anatomy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Anca Sindrilaru
- Department of Dermatology and Allergic Diseases, University Clinic Ulm, Germany
| | - Maria Crisan
- Departments of Dermatology and Histology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Doğan Y, Kara M, Culha MA, Özçakar L, Kaymak B. The relationship between vitamin D deficiency, body composition, and physical/cognitive functions. Arch Osteoporos 2022; 17:66. [PMID: 35420317 PMCID: PMC9008297 DOI: 10.1007/s11657-022-01109-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/06/2022] [Indexed: 02/03/2023]
Abstract
Vitamin D deficiency is still an important subject due to its significant effects on various tissues and functions. We found a relationship between vitamin D deficiency and increase in adipose tissue thicknesses. This situation reveals the importance of vitamin D supplementation, the harms of weight gain and obesity, and the importance of a balanced diet. PURPOSE Although the relationship between vitamin D (VitD) levels with body composition and physical/cognitive functions have been investigated in various studies, however, there is no study evaluating all these parameters together. In accordance with, we aimed to evaluate the relationship between VitD deficiency with body composition (i.e., skin, subcutaneous fat, and muscle thicknesses) and physical/cognitive functions. METHODS A total of 203 adults (78 M, 125 F, aged 19-91 years) who had recent 25-OH-vitamin D measurements were included. Ultrasonographic (US) measurements (skin, subcutaneous fat, and muscle thicknesses) were made from the dorsum of the hand, and anterior sides of forearm, arm, and thigh. Handgrip strength, gait speed, Timed Up and Go Test, and Chair Stand Test were evaluated. Additionally, cognitive status was also evaluated with Mini-Mental State Exam. RESULTS Subjects were classified as VitD deficient group (< 20 ng/ml, N = 125) and control group (≥ 20 ng/ml, N = 78). The groups were not significantly different as regards age, gender, and anthropometric measurements (all p > 0.05). Subcutaneous fat tissues were thicker in the VitD deficient group (all p < 0.05). All the other US measurements and functional/cognitive tests were not significantly different between the groups (all p > 0.05). According to linear regression analyses, body mass index (BMI) was independently related with all subcutaneous fat thicknesses in both genders, and VitD deficiency was related with all subcutaneous fat thicknesses in females and anterior forearm subcutaneous fat thickness in males (all p < 0.05). CONCLUSION We imply that together with BMI, VitD deficiency is independently related with increased regional subcutaneous fat tissue. We also underscore the role of US measurements for evaluation of body composition in related clinical scenarios.
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Affiliation(s)
- Yahya Doğan
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Zemin Kat FTR AD, Sıhhiye, Ankara, Turkey.
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Zemin Kat FTR AD, Sıhhiye, Ankara, Turkey
| | - Mehmet Ali Culha
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Zemin Kat FTR AD, Sıhhiye, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Zemin Kat FTR AD, Sıhhiye, Ankara, Turkey
| | - Bayram Kaymak
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Zemin Kat FTR AD, Sıhhiye, Ankara, Turkey
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Grover C, Bansal S, Varma A, Jakhar D. Radiological imaging in nail unit disorders (Part I) - Modalities used. Indian Dermatol Online J 2022; 13:449-456. [PMID: 36262575 PMCID: PMC9574134 DOI: 10.4103/idoj.idoj_3_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 11/11/2022] Open
Abstract
The nail unit is a unique skin appendage, capable of mounting only a limited number of reaction patterns to a variety of insults. This makes it difficult to diagnose many nail conditions based on clinical features alone. Thus, diagnostic modalities have an important role to play in nail disorders. Emphasis is placed on non-invasive diagnostic methods, of which, radiological imaging forms an important part; however, it is a field largely under-explored with very few studies and reports available in the literature. This could be due to the problems encountered in nail unit radiology including its small size, complex anatomy, requirement for special high-frequency probes to reliably evaluate superficial structures, and non-familiarity with nail unit radiological features even amongst trained radiologists. Nevertheless, it plays a useful role in diagnosing nail disorders (especially tumors), localizing the changes, exploring differential diagnoses, estimating prognosis, and planning management. This article is aimed at collating scientific data pertaining to various radiological modalities used in the diagnosis of nail diseases. The advantages and limitations of various imaging techniques used for evaluating the nail unit, including digital radiographs, high-frequency ultrasound, ultrasound doppler (USD), computed tomography (CT), and magnetic resonance imaging (MRI), are discussed in the first part. The second part will discuss the features of common and uncommon nail diseases.
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