RESUMO
Hidradenitis suppurativa (HS) is a devasting autoimmune cutaneous disease that affects the hair follicles and can clinically present palpable nodules, abscesses, and tunnels (fistulas), usually in the intertriginous regions. It has been widely reported that color Doppler ultrasound can detect subclinical abnormalities and stage the severity of the disease more accurately. Nevertheless, the ultrasound diagnostic criteria were reported with 15 MHz 10 years ago, and now it is possible to detect early anatomical abnormalities in HS using 70 MHz. Thus, an update of the ultrasonographic diagnostic criteria is needed. The most widely used sonographic staging of severity of HS (SOS-HS) includes the number of affected regions, besides counting the number of key lesions like pseudocysts, fluid collections, and tunnels; however, the total number of affected regions may fit better in an activity scoring. Furthermore, a high number of tunnels or communicated tunnels can complicate the management and may indicate an even more urgent treatment, which should be considered in the severity classification. To date, no hidradenitis scoring of activity has been reported in the literature, making it difficult to track the degree of inflammation under treatment objectively. Therefore, two new scorings are proposed. The first is an updated sonographic scoring of severity called modified SOS-HS (mSOS-HS), and the second is an activity ultrasound scoring of HS called US-HSA. Both staging systems can provide better anatomical information for discriminating the categories and, therefore, selecting more appropriate treatments and supporting research and clinical trials by giving more objective anatomical tools in real-world settings.
Assuntos
Fístula , Hidradenite Supurativa , Humanos , Hidradenite Supurativa/diagnóstico por imagem , Ultrassonografia , Abscesso , Ultrassonografia Doppler em Cores , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Lipomas are the most frequent benign tumor. They have been described as soft, well-defined, slow-growing palpable masses, and classified as deep or superficial. PURPOSE: To present the clinical and ultrasound findings of herniated superficial subcutaneous lipoma (HSL), located in pressure/support areas, not previously described. MATERIAL AND METHODS: A seven-year retrospective review was performed. Patients with a preoperative high-resolution ultrasound (HRUS) diagnosis of HSL archived in the computational system and histological study information were selected. RESULTS: A total of 37 patients (mean age = 46 years) were recruited. The clinical diagnoses were "lipoma" or "suspected lipoma" in just 46% of the cases. This was three times more frequent in women. Tumors were located mainly in the gluteal (38%) and proximal thigh areas (35%). Clinically, all patients showed small, soft, rounded skin nodules. On HRUS, they appear as lipomatous tumors that protruded, compressed, and thinned the covering dermal layer. The subcutaneous portion was bigger than the herniated part, with an iceberg image. CONCLUSION: HSL in support areas have a special clinical ultrasound presentation, not previously described. It is important to recognize them for a proper diagnosis and treatment, especially because they clinically may present as small superficial lesions; however, they are associated with a larger subcutaneous portion (iceberg image). It is probable that an estrogen influence on the adipose tissue can be suspected because of the female predominance.
Assuntos
Lipoma , Neoplasias de Tecidos Moles , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Coxa da Perna/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Lipoma/patologia , Diagnóstico Diferencial , Ultrassonografia , Estudos Retrospectivos , Neoplasias de Tecidos Moles/patologiaRESUMO
High-resolution ultrasound (HRUS) is an important diagnostic method in dermatology, especially in pediatric population. The most common type of cutaneous cysts in children corresponds to cysts with stratified squamous epithelium (CSSE). The objective is to present the different ultrasonographic appearance of histologically proven CSSE in a retrospective review. Epidermoid, milium, trichilemmal, dermoid, and pilonidal cyst and steatocystomas are included. Utility of HRUS in diagnosis of cutaneous lesions is well established. It is important to know-and stay updated-about the wide spectrum of ultrasonographic appearance of CSSE in order to avoid misleading diagnoses.
Assuntos
Carcinoma de Células Escamosas , Dermatologia , Cisto Epidérmico , Neoplasias Cutâneas , Humanos , Criança , Cisto Epidérmico/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Epitélio/patologiaRESUMO
OBJECTIVES: To assess the ultrasonographic patterns of different calcium hydroxyapatite (CaHA) formulations, including the undiluted, diluted, and mixed with hyaluronic acid (HA) compounds. METHODS: To review the ultrasonographic images of patients ≥18 years with confirmed injections of CaHA clinically and ultrasonographically, and without different concomitant types of fillers in the same region or other systemic or localized cutaneous diseases. RESULTS: Twenty-one patients met the criteria (90% female; 10% male; mean age: 52 years ± 12.8). Of these, 33.3% have been injected with an undiluted formulation, 33.3% with diluted, and 33.3% with a mixed formulation. All cases were studied with devices presenting frequencies that ranged from 18 to 24 MHz. Twelve cases (57%) were also studied with the 70 MHz. The ultrasonographic patterns of CaHA presented differences in the presence and intensity of PAS and the degree of inflammation according to the dilution and mix with HA. Diluted formulations show a milder intensity posterior acoustic shadowing (PAS) artifact than undiluted at 18-24 MHz. In mixed formulations, 57% showed mild PAS, and 43% demonstrated no PAS artifact at 18-24 MHz, besides fewer inflammatory changes in the periphery of the deposits. CONCLUSIONS: The ultrasonographic patterns of CaHA show differences in the presence and intensity of PAS and the degree of inflammation according to the dilution and mix with HA. Awareness of these ultrasonographic variations can support better discrimination of CaHA.
Assuntos
Técnicas Cosméticas , Envelhecimento da Pele , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Durapatita , Ácido Hialurônico , Inflamação , Adulto , Adolescente , Adulto JovemRESUMO
What points to consider when selecting a device for practicing dermatologic ultrasound is an excellent question. After we met the requisites published in the guidelines for practicing dermatologic ultrasound, it is necessary to consider the main objective of the use because it is not the same to be focused mostly on the avoidance of the puncture of important facial vessels such as the case of injectors of cosmetic fillers in comparison to the use of operators that need to deal with the diagnosis and monitoring of a wide range of dermatologic pathologies. Currently, a broad variety of ultrasound devices meets the minimum requirements for practicing these examinations in the market. Thus, small, portable, and high-end devices may present advantages and limitations that must be balanced according to the primary purposes and the budget. Moreover, the shape and footprint of the probes can make difficult or facilitate a dermatologic procedure. Other points to consider are the type of storage and the need for technical service. In summary, there are key points that we need to consider when we select a dermatologic ultrasound device in dermatology or aesthetics.
Assuntos
Ultrassonografia , Humanos , InjeçõesRESUMO
The advances in dermatologic ultrasound have been significantly influenced by the development of high- and ultrahigh-frequency probes, the provision of guidelines for performing the examinations, and a growing number of publications in the field. This review analyzes the most significant contributions that have impacted the daily practice of dermatologists in recent years. This includes the advances in anatomical detection and the patterns of benign and malignant cutaneous tumors, inflammatory dermatologic conditions, vascular anomalies, nail abnormalities, and aesthetic procedures. The knowledge of these advances is a primer for the operators of these examinations.
Assuntos
Neoplasias Cutâneas , Doenças Vasculares , Humanos , Ultrassonografia , Exame FísicoRESUMO
BACKGROUND: Detection of activity in morphea is paramount for adequately managing the disease. Subclinical ultrasound involvement on inactive lesions or healthy skin areas adjacent to morphea has not been described to date. OBJECTIVES: The study aimed to detect morphea's subclinical activity by Color Doppler ultrasound not identified with the clinical scorings. MATERIALS & METHODS: This cross-sectional retrospective study was done from January 2014 to July 2019 in patients with a clinicopathological diagnosis of morphea. The modified Localized Scleroderma Skin Severity Index (mLoSSI) and The Ultrasound Morphea Activity Score (US-MAS) were used to correlate clinical and subclinical activity. RESULTS: A total of 36 patients met the inclusion criteria. 54% of cases presented subclinical activity in areas adjacent to the clinically active lesion, 23% in nonadjacent regions, and 23% demonstrated activity at a clinically inactive lesion site.100% of patients with morphea "en coup de sabre" involving the frontal region of the face concomitantly presented both subclinical activities of morphea on the frontal facial region and the scalp following the same axis.A positive relationship was observed between the degree of clinical activity measured by mLoSSI and US-MAS scoring.The main limitations of our study were the low number of patients and the inability to detect alterations < 0.1 mm. CONCLUSIONS: Subclinical activity is frequent in morphea, can extend beyond the lesional areas, including apparently noninvolved adjacent and distant corporal regions, and can be detected by color Doppler ultrasound.
Assuntos
Esclerodermia Localizada , Humanos , Esclerodermia Localizada/diagnóstico por imagem , Esclerodermia Localizada/patologia , Estudos Retrospectivos , Estudos Transversais , Pele/patologia , Ultrassonografia Doppler em CoresRESUMO
High-frequency ultrasonography (HFUS) is a non-invasive and highly repetitive medical imaging method with a great and still rising value in the diagnostic process of skin tumours. It accompanies the physician's examination, dermoscopy, and biopsy; facilitates real-time assessment of locoregional staging and planning of surgical excision; and provides postoperative inspection of treatment results. The aim of this review article is to discuss HFUS application in common cutaneous malignant tumours while depicting the use of both the grayscale and colour Doppler methods.
RESUMO
BACKGROUND: Deep-learning algorithms (DLAs) have been used in artificial intelligence aided ultrasonography diagnosis of thyroid and breast lesions. However, its use has not been described in the case of dermatologic ultrasound lesions. Our purpose was to train a DLA to discriminate benign form malignant lesions in dermatologic ultrasound images. MATERIALS AND METHODS: We trained a prebuilt neural network architecture (EfficientNet B4) in a commercial artificial intelligence platform (Peltarion, Stockholm, Sweden) with 235 color Doppler images of both benign and malignant ultrasound images of 235 excised and histologically confirmed skin lesions (84.3% training, 15.7% validation). An additional 35 test images were used for testing the algorithm discrimination for correct benign/malignant diagnosis. One dermatologist with more than 5 years of experience in dermatologic ultrasound blindly evaluated the same 35 test images for malignancy or benignity. RESULTS: EfficientNet B4 trained dermatologic ultrasound algorithm sensitivity; specificity; predictive positive values, and predicted negative values for validation algorithm were 0.8, 0.86, 0.86, and 0.8, respectively for malignancy diagnosis. When tested with 35 previously unevaluated images sets, the algorithm´s accuracy for correct benign/malignant diagnosis was 77.1%, not statistically significantly different from the dermatologist's evaluation (74.1%). CONCLUSION: An adequately trained algorithm, even with a limited number of images, is at least as accurate as a dermatologic-ultrasound experienced dermatologist in the evaluation of benignity/malignancy of ultrasound skin tumor images devoid of clinical data.
Assuntos
Aprendizado Profundo , Neoplasias Cutâneas , Inteligência Artificial , Humanos , Redes Neurais de Computação , Sensibilidade e Especificidade , Neoplasias Cutâneas/diagnóstico por imagem , UltrassonografiaRESUMO
Cutaneous pseudolymphomas are reactive lymphoproliferations. The most frequent type is nodular pseudolymphoma, and to date, their ultrasonographic appearance has not been reported. We reviewed the ultrasound images of histologically confirmed nodular types of pseudolymphomas studied with 18 and 71 MHz linear probes. All lesions were predominantly hypoechoic and presented prominent vascularity. Seventy percent of cases involved dermis and hypodermis, and 30% were only dermal. Seventy percent of cases showed internal hypoechoic globules, and 100% presented a teardrop sign, more clearly detected at 71 MHz. Ultrasound can support the diagnosis, assessment of the extent, and degree of vascularity of cutaneous nodular pseudolymphomas.
Assuntos
Pseudolinfoma , Diagnóstico Diferencial , Humanos , Pseudolinfoma/diagnóstico por imagem , UltrassonografiaRESUMO
Morphea, a localized form of scleroderma, is a chronic inflammatory autoimmune disease of the skin. Color Doppler Ultrasound has been reported as a reliable tool to assess the activity of the disease. With histologically confirmed cases, this case series describes a new ultrasound sign consisting of a hyperechoic halo surrounding superficial subcutaneous veins of the extremities in transverse view, named the sun sign. This sign can help diagnose morphea in the inflammatory phase and correlate in pathology with perivascular infiltrates surrounding superficial subcutaneous veins.
Assuntos
Esclerodermia Localizada , Doença Crônica , Humanos , Esclerodermia Localizada/diagnóstico por imagem , Esclerodermia Localizada/patologia , Pele/diagnóstico por imagem , Ultrassonografia , Ultrassonografia Doppler em CoresRESUMO
BACKGROUND: High-frequency ultrasound (HFUS) using a 20 MHz probe is a non-invasive assessment tool. Its utility in dermatology for diagnosis of disease or for monitoring of treatment response in various dermatological conditions is still being explored. Edema secondary to venous hypertension is the main pathogenic factor in the development of venous leg ulcers. However, there is no objective method for assessment of degree of edema. In this study, we explore the utility of high-frequency ultrasound in assessing cutaneous edema and for monitoring its improvement with compression therapy among patients with venous ulcer. MATERIALS AND METHODS: Twenty patients with venous ulcer were enrolled in the study. Measurement of cutaneous edema was done at baseline and after 2 weeks of compression therapy in all patients. The 3 levels of measurement were dorsum of foot (low site, L1), 4 cm proximal to the medial malleolus (middle site, L2), and the medial aspect of the calf between the medial malleolus and the knee (upper site, L3). RESULTS: Baseline subepidermal low echogenic band (SLEB) measurements were 2.46 ± 0.69 mm, 2.94 ± 0.65 mm, and 2.66 ± 0.64 mm at L1, L2, and L3, respectively. There was a significant reduction in SLEB measurement after compression therapy ( p values 0.008, 0.002, and 0.003 at L1, L2, and L3, respectively). The mean percentage reduction in SLEB at level of medial malleolus (mid level - 29.61 ± 12.24) was higher than the other 2 sites (L1-22.45 ± 15.83 and L3 were 27.57 ± 12.34). CONCLUSION: Cutaneous ultrasound aids in accurate assessment of level and severity of edema. Hence, it can be utilized in trials to objectively assess the adequacy of treatment for patients with venous insufficiency.
Assuntos
Úlcera da Perna , Úlcera Varicosa , Insuficiência Venosa , Edema/diagnóstico por imagem , Edema/etiologia , Humanos , Pele/diagnóstico por imagem , Ultrassonografia , Úlcera Varicosa/diagnóstico por imagem , Úlcera Varicosa/terapia , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/terapiaRESUMO
OBJECTIVES: Infantile hemangiomas (IHs) are the most common benign tumors in children. Color Doppler ultrasound is a noninvasive imaging modality that can show subclinical anatomic parameters in a wide range of dermatologic conditions. The purpose of this study was to describe the ultrasound characteristics of IHs and look for subclinical features with the potential to influence the involution and therapeutic response. METHODS: A review of the ultrasound database of children with clinical and ultrasound IH diagnoses was conducted. The clinically reported duration and the ultrasound assessment of the proliferative phase were compared. Descriptive and statistical analyses of qualitative and quantitative parameters of the series were performed. Significance was set at P < .05. RESULTS: A total of 204 IHs were included. Twenty percent had arteriovenous shunts; 15% had afferent branches from main regional arteries; and almost 30% showed involvement of deep structures. Sixty-one percent of IHs were in the head and neck. Deep hemangiomas showed significantly thicker lesional vessels. A prolonged proliferative stage was significantly associated with a higher presence of arteriovenous shunts and a higher peak systolic velocity of the arterial vessels (≥15 cm/s) within the lesions. CONCLUSIONS: Color Doppler ultrasound can support the detection of subclinical anatomic features that may potentially influence the involution and response to treatment of IHs. Some of these characteristics may serve as potential markers to predict and manage IHs in prolonged proliferative stages.
Assuntos
Hemangioma , Neoplasias Cutâneas , Criança , Hemangioma/diagnóstico por imagem , Humanos , Lactente , Pescoço , Neoplasias Cutâneas/diagnóstico por imagem , Ultrassonografia , Ultrassonografia Doppler em CoresRESUMO
Chronic exposure to trauma, friction, or extreme conditions can generate cutaneous or ungual lesions in sports and certain occupations. Although some of these dermatologic conditions are diagnosed with a naked-eye examination, there are cases in which the provision of the underlying anatomic alterations can be helpful for the diagnosis and management. In comparison with computed tomography or magnetic resonance imaging, ultrasound has the highest axial resolution, which is critical for the observation of anatomic changes in the skin and nail. We review the ultrasound characteristics of frequent cutaneous and ungual lesions related to sports and occupations with a clinical correlation. The ultrasound features in some particular conditions such as "biker's and surfer's panniculitis," "fiddler's neck," piezogenic papules, and lipoatrophy semicircularis, among others, are discussed.
Assuntos
Dermatologia , Dermatopatias , Esportes , Humanos , Pele/diagnóstico por imagem , Dermatopatias/diagnóstico por imagem , UltrassonografiaRESUMO
Nevus sebaceous of Jadassohn (NSJ) is a cutaneous hamartoma commonly found in the scalp and face and more frequent in children. Clinically, it presents as a yellowish and hairless plaque. In later stages, the NSJ can develop secondary tumors, including skin cancer. We reviewed the ultrasound characteristics of 9 patients (67% female; mean age, 3 years) with NSJ at 18 and 70 MHz. The ultrasound analysis covers the data on the location, thickness, echo structure, and vascularity. The provision of the ultrasound patterns of NSJ can support early diagnosis, avoid unnecessary biopsies, and support monitoring.
Assuntos
Nevo Sebáceo de Jadassohn , Nevo , Neoplasias Cutâneas , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Nevo/diagnóstico por imagem , Couro Cabeludo/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , UltrassonografiaRESUMO
The purpose of the work is to assess changes in the functional state of the microvasculature, study of the features of the morphological parameters of the skin by non-invasive research methods for various morphotypes of aging. The study involved 55 patients with involutional changes in the lower third of the face aged 35 to 65 years, included according with the inclusion and exclusion criteria. 4 morphotypes of aging were identified, depending on which patients were divided into corresponding groups: 1st - 19 patients with deformational type, 2nd - 17 with tired type, 3rd - 8 with fine wrinkled type, 4th - 11 with mixed morphotype of aging. To study the condition of the patients' skin, laser Doppler flowmetry and ultrasound examination of the skin (22 Mhz) were used. The method of laser Doppler flowmetry revealed significant changes when comparing microcirculation indices and the ultrasound method for examining deformational and fine wrinkled type (p<0,05). In the deformational type and mixed type, a predominantly atonic type of microcirculation was observed (9,42±3,71 and 9,56±2,31 perf. u., respectively), and in fine wrinkled spastic type of microcirculation (7,86±1,6 perf. u.), in the oral morphotype the microcirculation index was within the normal range of 7,86±1,6 perf. u. The data of ultrasound examination of the skin made it possible to reveal in the deformational morphotype of aging high values of the thickness of the epidermis (125,94±27,84 µm), the dermis (1 439±118,11 µm) and the density of the dermis (12±2,59 a. u.) compared with the thickness of the epidermis 85±22,01 µm, the thickness of the dermis (1 130±68,55 µm) and the density of the dermis (7,87±2,1 c. u.) in the fine wrinkled morphotype of aging.
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Envelhecimento da Pele , Envelhecimento , Humanos , Fluxometria por Laser-Doppler , Microcirculação , PeleRESUMO
OBJECTIVE: High frequency ultrasound allows visualization of epidermis, dermis and hypodermis, precise measurement of skin thickness, as well as assessment of skin oedema, fibrosis and atrophy. The aim of this pilot cross-sectional observational study was to assess the performance and multiobserver variability of ultra-high-frequency (UHF) (50 MHz) ultrasound (US) in measuring skin thickness as well as the capacity of UHF-derived skin features to differentiate SSc patients from healthy controls. METHODS: Twenty-one SSc patients (16 limited and five diffuse SSc) and six healthy controls were enrolled. All subjects underwent US evaluation by three experts at three anatomical sites (forearm, hand and finger). Dermal thickness was measured and two rectangular regions of interest, one in dermis and one in hypodermis, were established for texture feature analysis. RESULTS: UHF-US allowed a precise identification and measurement of the thickness of the dermis. The dermal thickness in the finger was significantly higher in patients than in controls (P < 0.05), while in the forearm it was significantly lower in patients than in controls (P < 0.001). Interobserver variability for dermal thickness was good to excellent [forearm intraclass correlation coefficient (ICC) = 0.754; finger ICC = 0.699; hand ICC = 0.602]. Texture computed analysis of dermis and hypodermis was able to discriminate between SSc and healthy subjects (area under the curve >0.7). CONCLUSION: These preliminary data show that skin UHF-US allows a very detailed imaging of skin layers, a reliable measurement of dermal thickness, and a discriminative capacity between dermis and hypodermis texture features in SSc and healthy subjects.
Assuntos
Antebraço/diagnóstico por imagem , Mãos/diagnóstico por imagem , Escleroderma Sistêmico/diagnóstico por imagem , Pele/diagnóstico por imagem , Ultrassonografia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Adulto JovemRESUMO
BACKGROUND: Hidradenitis suppurativa is a chronic inflammatory skin disease. An ultrasound staging (SOS-HS) using frequencies from 7 to 18 MHz has been proposed to evaluate the severity of the disease. MATERIALS AND METHODS: We retrospectively evaluated the most significant lesions in 50 patients with hidradenitis suppurativa (32 females and 18 males, aged from 12 to 68 years old), who had undergone high-frequency ultrasound (HFUS) (18-22 MHz) and ultra-high frequency ultrasound (UHFUS) (48 and 70 MHz). A MyLab™ Touch system (Esaote) equipped with a 18-22 MHz linear probe was used for the HFUS, and a Vevo® MD (VisualSonics) was used for the UHFUS, equipped with two linear probes (70 and 48 MHz). RESULTS: A total of 116 lesions were observed, of which 66 were fluid collections, 32 were tunnels, 6 pseudocysts, 5 bridge scars, 5 tombstone comedones, and 2 granulation tissues. Structures that had already been described with HFUS were then observed with UHFUS but with a better definition. In addition, structures that had not been detected by HFUS were also observed with UHFUS such as drop-shaped hair follicles, micro-tunnels, and microcysts. CONCLUSION: Ultra-high frequency ultrasound provides a better understanding of hidradenitis suppurativa. Patients can be monitored more effectively thereby preventing the most severe changes.
Assuntos
Hidradenite Supurativa , Adolescente , Adulto , Idoso , Criança , Progressão da Doença , Feminino , Folículo Piloso/diagnóstico por imagem , Hidradenite Supurativa/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ultrassonografia , Adulto JovemRESUMO
OBJECTIVES: To test the capability of 70-MHz ultrasound for detecting initial ultrasound signs of hidradenitis suppurativa (HS) linked to severity. METHODS: A cross-sectional study of the ultrasound images of patients with HS was conducted and compared with a healthy control group. Detection and identification of early subclinical ultrasound signs in the lesional and perilesional areas of the HS cases in comparison with the control group were performed. Statistical analyses included mean, dispersion measures, the Kruskal-Wallis test, and bivariate and multivariate ordered logistic regression studies. Significance was assessed at P < .05. RESULTS: A total of 139 patients with HS met the criteria and showed abnormalities of the hair follicles such as a curved shape, ballooning, and protrusion into pseudocysts, collections, or tunnels (donor of keratin sign). Significant increases in the sizes of the hair follicles and hair shafts were found in HS cases. The following ultrasound signs were significantly linked to severity: a connecting band between the base of adjacent hair follicles (bridge sign), a fragment of the hair shaft extruding through a dilated hair follicle (sword sign), and retained cylindrical fragments of keratin in the dermis. Two patterns of fragmentation of the keratin were detected: multifragment and cylindrical. CONCLUSIONS: Ultrasound can detect early HS signs that are significantly linked to severity and 2 types of fragmentation of the keratin, which could support the generation and perpetuation of the fluid collections and tunnels. These ultrasound signs can help prompt diagnosis and management, the development and testing of medications, and the measure of treatment outcomes in HS.
Assuntos
Hidradenite Supurativa/diagnóstico por imagem , Queratinas/metabolismo , Ultrassonografia/métodos , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Folículo Piloso/diagnóstico por imagem , Folículo Piloso/metabolismo , Folículo Piloso/fisiopatologia , Hidradenite Supurativa/metabolismo , Hidradenite Supurativa/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto JovemRESUMO
The ultrasound features of 87 steatocytoma multiplex (SCM) lesions detected in 9 patients are reported. Steatocytoma multiplex is a hamartomatous condition derived from the pilosebaceous duct junction that generates multiple cutaneous cystic lesions. It appeared as clusters of well-defined hypoechoic nodules with mild posterior enhancement in 100% of cases, with both dermal and subcutaneous locations in 67%. No calcification foci were detected within or at the periphery of the lesions. Fifty-six percent of the cases showed signs of hypervascularity in the edge of the nodules, and 44% of the lesions were associated with another dermatologic condition, most frequent being hidradenitis suppurativa (75%), followed by vellus hair cysts (25%). Steatocytoma multiplex shows ultrasound features that allow discrimination from other common cutaneous entities.