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Non‐invasive evaluation of inflammation in atopic dermatitis *
Author(s) -
Hoffmann Klaus,
Dirschka Thomas,
Schwarze Hartmut,
Stücker Markus,
ElGammal Stefan,
Hoffmann Andrea,
Altmeyer Peter
Publication year - 1994
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/j.1468-3083.1994.tb00374.x
Subject(s) - medicine , erythema , lesion , atopic dermatitis , dermatology , edema , echogenicity , ultrasound , radiology , pathology , surgery
In atopic dermatitis the inflammatory reaction is quantified either clinically or histologically. While clinical evaluation has the major disadvantage of inter‐ and intraoperator variance, histological investigation requires invasive procedures. Therefore, standard techniques which provide both an objective and non‐invasive form of examination are desirable. We investigated 20 patients with atopic dermatitis by means of high resolution 20‐MHz b‐*scan ultrasound. Investigations were performed on inflammatory skin lesions at regular intervals using a standardized combination of external treatment with α‐methyl‐prednisolon‐aceponat ointment and UV‐A/UV‐B phototherapy until the lesions had healed. Skin colour (erythema) was assessed with the Minolta Chromameter CR 200 colorimeter according to the L*a*b* colour system. Sonograms of affected skin show a zone of low echogenicity below the so‐called entry‐echo. We refer to this as the echolucent area. Healing of a lesion is seen as a decrease in thickness and an increase in density of the skin in the sonographic image; the echolucent area disappears totally when the lesion has clinically healed. In five patients we excised small areas of skin to compare the sonographic and histological pictures of exactly the same site. This showed that the thickness of the subepidermal echolucent area corresponds to the inflammatory reaction representing both edema and cellular infiltration. Comparing the findings in sonography with the change in skin colour measurements we found that the a*‐value of the L*a*b* colour system representing redness correlated well with the sonographic density of the echolucent area. In conclusion, 20‐MHz‐b‐scan sonography and colorimetry are suitable methods for non‐invasive, objective evaluation of the inflammatory process in atopic dermatitis.