Non-invasive imaging and clinical skin scores in juvenile localized scleroderma

Pain,Clare E.; Murray,Andrea; Dinsdale,Graham; Marsden,Antonia; Manning,Joanne; Riley,Phil; Leone,Valentina; Amin,Tania; Zulian,Francesco; Herrick,Ariane L.

Non-invasive imaging and clinical skin scores in juvenile localized scleroderma

All Authors

Pain,Clare E.

Murray,Andrea

Dinsdale,Graham

Marsden,Antonia

Manning,Joanne

Riley,Phil

Leone,Valentina

Amin,Tania

Zulian,Francesco

Herrick,Ariane L.

LTHT Author

Amin, Tania

LTHT Department

Leeds Children's Hospital
Paediatric Rheumatology

Publication Date

2024

Item Type

Article

Abstract

Objectives To evaluate whether in juvenile localized scleroderma (JLS), non-invasive imaging can differentiate affected from non-affected skin and whether imaging correlates with a validated skin score Localised Scleroderma Cutaneous Assessment Tool (LoSCAT)]. Methods A total of 25 children with JLS were recruited into a prospective study and a single 'target' lesion was selected. High-frequency ultrasound (HFUS, measuring skin thickness), infrared thermography (IRT, skin temperature), laser Doppler imaging (LDI, skin blood flow) and multispectral imaging (MSI, oxygenation) were performed at four sites: two of affected skin (centre and inner edge of lesion) and two of non-affected skin (1?cm from the edge of the lesion 'outer' and contralateral non-affected side) at four visits at 3?month intervals. Results Differences between affected and non-affected skin were detected with all four techniques. Compared with non-affected skin, affected skin was thinner (P ?<?0.001), with higher temperature (P ?<?0.001�006), perfusion (P ?<?0.001�039) and oxygenation (P ?<?0.001�028). Lesion skin activity (LoSCAT) was positively correlated with centre HFUS r ?=?0.32 (95% CI 0.02, 0.61), P ?=?0.036] and negatively correlated with centre LDI r ?=??0.26 (95% CI ?0.49, ?0.04), P ?=?0.022]. Lesion skin damage was positively correlated with centre and inner IRT r ?=?0.43 (95% CI 0.19, 0.67), P ?<?0.001 and r ?=?0.36 (95% CI 0.12, 0.59), P ?=?0.003, respectively] and with centre and inner LDI r ?=?0.37 (95% CI 0.05, 0.69), P ?=?0.024 and r ?=?0.41 (95% CI 0.08, 0.74), P ?=?0.015, respectively]. Conclusion Non-invasive imaging can detect differences between affected and non-affected skin in JLS and may help to differentiate between activity (thicker, less well-perfused skin) and damage (thinner, highly perfused skin).