Potential of high‑frequency ultrasonography in the management of atopic dermatitis

Atopic dermatitis (AD) is a chronic, highly pruritic skin disorder, with a broad spectrum of clinical manifestations, characterized by abnormal skin barrier function. High-frequency ultrasonography (HF-USG) is an instrument with potential use in a variety of skin conditions. Previous studies on HF-USG in AD reported that apparently non-lesional skin also presents barrier defects. We aimed to assess lesional and non-lesional skin of AD patients with the use of HF-USG, focusing on skin barrier function and inflammation. We included a group of AD patients and a control group. On both we performed analysis with the use of HF-USG. The thickness of the subepidermal low-echogenic band (SLEB) and the skin echogenity were recorded for active lesions, as well as non-lesional skin in all subjects included. For AD patients the clinical severity was measured using SCORing Atopic Dermatitis and correlated with Dermatology Life Quality Index (DLQI). The mean thickness of the hypoechoic band was wider in the lesional skin of AD. In the non-lesional skin of AD patients SLEB was identified to appear, but it was thinner. The skin echogenity of the control group was higher than that of AD patients. Our results indicate that skin ultrasonography is able to assess specific modifications of the AD skin. A hypoechoic band in the non-lesional skin of some AD patients may indicate subclinical eczematous lesions.