Subject(s)
Hemangioma, Capillary , Hemangioma , Skin Neoplasms , Humans , Infant , Propranolol/therapeutic use , Nadolol/therapeutic use , Hemangioma, Capillary/drug therapy , Hemangioma/drug therapy , Adrenergic beta-Antagonists/therapeutic use , Treatment Outcome , Skin Neoplasms/drug therapy , Administration, OralSubject(s)
Hemangioma, Capillary , Hemangioma , Skin Neoplasms , Humans , Infant , Propranolol/therapeutic use , Nadolol/therapeutic use , Hemangioma, Capillary/drug therapy , Hemangioma/drug therapy , Adrenergic beta-Antagonists/therapeutic use , Treatment Outcome , Skin Neoplasms/drug therapy , Administration, OralABSTRACT
BACKGROUND: It has been reported that clinical evaluation consistently underestimates the severity of hidradenitis suppurativa (HS). OBJECTIVE: To determine the usefulness of ultrasound as a diagnostic tool in HS compared with clinical examination and to assess the subsequent modification of disease management. METHODS: Cross-sectional multicentre study. Severity classification and therapeutic approach according to clinical vs. ultrasound examination were compared. RESULTS: Of 143 HS patients were included. Clinical examination scored 38, 70 and 35 patients as Hurley stage I, II and III, respectively; with ultrasound examination, 21, 80 and 42 patients were staged with Hurley stage I, II and III disease, respectively (P < 0.01). In patients with stage I classification as determined by clinical examination, 44.7% changed to a more severe stage. Clinical examination indicated that 44.1%, 54.5% and 1.4% of patients would maintain, increase or decrease treatment, respectively. For ultrasound examination, these percentages were 31.5%, 67.1% and 1.4% (P < 0.01). Concordance between clinical and ultrasound intra-rater examination was 22.8% (P < 0.01); intra-rater and inter-rater (radiologist) ultrasound agreement was 94.9% and 81.7%, respectively (P < 0.01). LIMITATIONS: The inability to detect lesions that measure ≤0.1 mm or with only epidermal location. CONCLUSION: Ultrasound can modify the clinical staging and therapeutic management in HS by detecting subclinical disease.
Subject(s)
Hidradenitis Suppurativa/diagnostic imaging , Hidradenitis Suppurativa/therapy , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Severity of Illness Index , UltrasonographySubject(s)
Foot Deformities, Acquired/etiology , Foot Diseases/diagnostic imaging , Neurilemmoma/diagnostic imaging , Peripheral Nervous System Neoplasms/diagnostic imaging , Aged, 80 and over , Foot Diseases/complications , Foot Diseases/pathology , Foot Diseases/surgery , Foot Ulcer/etiology , Humans , Male , Neurilemmoma/complications , Neurilemmoma/pathology , Neurilemmoma/surgery , Peripheral Nervous System Neoplasms/complications , Peripheral Nervous System Neoplasms/pathology , Peripheral Nervous System Neoplasms/surgery , Time Factors , Ultrasonography, DopplerABSTRACT
Cutaneous ultrasound is a dermatological diagnostic imaging technique based on the interaction of high-frequency ultrasounds with the skin. Because it is non-invasive, rapid and accessible, it has increasingly wide clinical applications. This article reviews its use in the management of inflammatory dermatological diseases.
Subject(s)
Inflammation/diagnostic imaging , Skin Diseases/diagnostic imaging , Ultrasonography , Humans , Inflammation/therapy , Skin/diagnostic imaging , Skin Diseases/therapyABSTRACT
Hidradenitis suppurativa is a debilitating chronic, recurrent, inflammatory cutaneous disease of the hair follicle that usually presents with painful, deep and inflamed lesions in the areas of the body with apocrine glands, most frequently the axillary, groin and anogenital regions. This entity is difficult to manage since it can be difficult to determine the true nature and extension of the lesions. Cutaneous ultrasound allows real-time visualization of the cutaneous structures under examination, defining the type of lesion, its anatomical extension, and the degree of inflammatory activity, which affects adequate patient management. The present review analyses the importance of ultrasound in the assessment of patients with hidradenitis suppurativa.
Subject(s)
Hidradenitis Suppurativa/diagnostic imaging , Skin/diagnostic imaging , Ultrasonography , Apocrine Glands/pathology , Hair Follicle/pathology , HumansSubject(s)
Carcinoma, Renal Cell/genetics , Kidney Neoplasms/genetics , Leiomyomatosis/diagnosis , Neoplastic Syndromes, Hereditary/diagnosis , Skin Neoplasms/secondary , Uterine Neoplasms/diagnosis , Cystadenoma, Mucinous , Female , Humans , Leiomyomatosis/complications , Leiomyomatosis/genetics , Leiomyomatosis/pathology , Middle Aged , Neoplasms, Second Primary , Neoplastic Syndromes, Hereditary/complications , Neoplastic Syndromes, Hereditary/pathology , Ovarian Neoplasms , Pain/etiology , Skin Neoplasms/complications , Skin Neoplasms/diagnosis , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Uterine Neoplasms/complications , Uterine Neoplasms/genetics , Uterine Neoplasms/pathologySubject(s)
Humans , Female , Adult , Autoimmune Diseases/complications , Autoimmune Diseases/diagnosis , Skin Diseases/complications , Skin Diseases/immunology , Interferons/therapeutic use , Scleroderma, Localized/complications , Scleroderma, Localized/diagnosis , Vitiligo/complications , Vitiligo/diagnosis , Scleroderma, Localized/drug therapy , Scleroderma, Localized/physiopathology , Vitiligo/physiopathology , Prospective StudiesABSTRACT
Dermatofibroma (DF), a common benign skin tumour, sometimes requires treatment either because of cosmetic concern or for associated symptoms. However, no effective treatment with optimal cosmetic outcomes has been reported. An effective and safe therapeutic option could be treatment with pulsed dye laser (PDL). Twenty-two DFs in 15 patients were treated with PDL at 595-nm wavelength, using a spot size of 7 mm, a pulse duration of 2 ms and a fluence of 11 J/cm(2) with 2 or 3 stacked pulses. Clinical and dermoscopic photographs were taken before and after therapy. Global clinical improvement was higher than 50% in 12 lesions. Patient satisfaction assessment showed 73% of patients as satisfied or very satisfied. All lesions showed changes from the previous dermoscopic pattern. We consider that PDL could be a safe, palliative treatment as it is well accepted by patients and has a better cosmetic outcome than surgical excision.