Strain Index Values in the Ultrasonographic Evaluation of Psoriasis

Abstract

Objective: Psoriasis is a widespread, chronic, recurrent, inflammatory disease of the skin which affects men and women equally. Elastography is a novel technique which uses the elasticity of the lesion. The aim of this study is to determine the elastographic findings of dermal psoriasis. This is the first study to evaluate SI in psoriasis patients and SI is helpful to evaluate psoriasis patients. We suggest that determining cut-off SI values for normal and dermal psoriasis can be helpful in the early diagnosis and follow-up of psoriasis patients. Materials and Methods: This prospective study included a total of 21 (10 females, 11 males) healthy volunteers and 32 (17 females, 15 males) psoriasis patients between 2015 and 2016. An Aplio 500 ultrasound device (Toshiba Medical Systems Corp., Otawara, Japan) and a 5-13 MHz linear transducer were used for ultrasonographic and ultrasound elastographic examinations. The measurements were made from the flexor sides of upper and lower extremities. At least three measurements were performed for each lesion and strain index (SI) values were recorded Results: The median SI values of healthy volunteers and psoriasis were 1.25 (0.16-8.00) (interquartile range (IR) 1.50) and 2.73 (0.43-13.32) (IR 3.39), respectively, indicating a significant difference between the groups (p: 0.001). Conclusion: Our study results showed that the SI values of the dermis in psoriasis patients were significantly higher than those of healthy volunteers. We suggest that determining cut-off SI values for normal and dermal psoriasis can be helpful in the early diagnosis and follow-up of psoriasis patients. Advances in Knowledge: Due to the literature search, this is the first study to evaluate SI in psoriasis patients and SI is helpful to evaluate psoriasis patients.

Keywords

• Elastography,ultrasonography,psoriasis

References

1. 1. Barankin B, De Koven J. Psychosocial effect of common skin disease. Can Fam Psychian 2002;48:712-716
2. 2. Richards H.L., Fortune D.G., Griffiths C.E.M., Main J.C.The conturbation of perception of stigmatisitation to disaability in patients with psoriasis.Journal of psychosomatic research 2001;50:11-15.
3. 3. Krueger, Gerald G., and Madeleine Duvic. "Epidemiology of psoriasis: clinical issues." Journal of investigative dermatology 1994; 102: 14-18.
4. 4. Patel RV, Lebwohl M. Psoriasis. Annals of internal medicine. 2011 Aug 2;155(3):ITC2-1.-1.
5. 5. Ophir, J., Cespedes, I., Ponnekanti, H., Yazdi, Y., & Li, X. Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrasonic imaging, 1991;13, 111-134..
6. 6. Menzilcioglu, M. S., Duymus, M., Citil, S.Strain wave elastography for evaluation of renal parenchyma in chronic kidney disease. The British journal of radiology, 2015; 88, 20140714.
7. 7. Onur, M. and C. Göya, Ultrasound elastography: abdominal applications. Türkiye Klinikleri J Radiology Special Topics, 2013. 6: p. 59-69.
8. 8. Bamber, J., Cosgrove, D., Dietrich, C. F., et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall in der Medizin-European Journal of Ultrasound, 2013; 34, 169-184..

9. 9. Grover, C., Reddy, B. S. N., & Uma Chaturvedi, K. Diagnosis of nail psoriasis: importance of biopsy and histopathology. British Journal of Dermatology, 2005;153(6), 1153-1158.
10. 10. Afsar, F. S., Aktas, S., Diniz, G.,et al. Pediyatrik Dermatopatolojide Biyopsinin Rolü/The Role of Biopsy in Pediatric Dermatopathology. Turkderm, 2011; 45(3), 137.
11. 11. Liu, B., Zheng, Y., Huang, G.et al. Breast Lesions: Quantitative Diagnosis Using Ultrasound Shear Wave Elastography—A Systematic Review and Meta-Analysis. Ultrasound in medicine & biology, 2016; 42, 835-847..
12. 12. Gkali, C. A., Chalazonitis, A. N., Feida, E. et al. Breast Elastography: How We Do It. Ultrasound quarterly, 2015; 31, 255-261..
13. 13. Carlsen, J., Ewertsen, C., Sletting, S.et al. Ultrasound elastography in breast cancer diagnosis. Ultraschall in der Medizin-European Journal of Ultrasound, 2015; 36, 550-565..