Correlation between 75 MHz high-frequency ultra-sound and histopathology in psoriatic lesions.

Abstract

Background: High-frequency ultrasound (HFUS) at frequencies >20 MHz is a valuable non-invasive tool for high-resolution skin imaging, enabling quantitative assessment of epidermal and dermal morphology with an axial resolution of 21 μm. Such precision supports objective monitoring of dermatoses, including psoriasis.

Objectives: To compare epidermal and dermal measurements of psoriatic lesions using 75 MHz HFUS and histopathology.

Methods: Thirty psoriatic papules/plaques were imaged with 75 MHz HFUS (axial resolution: 21 μm) in patients who were referred for diagnostic biopsy, measuring epidermal thickness and subepidermal hypo-anechoic zone thickness. Lesions were marked for biopsy alignment, and histologic sections were evaluated along the same axis. Spearman's correlation analyzed agreement between methods.

Results: Mean epidermal thickness was 220 ± 33 μm (HFUS) vs. 215 ± 35 μm (histopathology; R = 0.82, p < 0.01). subepidermal hypo-anechoic zone thickness was 483 ± 97 μm (HFUS) vs. 448 ± 89 μm (histopathology; R = 0.88, p < 0.01). No significant inter-method differences were observed.

Conclusion: 75 MHz HFUS correlates strongly with histopathology in measuring psoriatic epidermal and dermal inflammatory changes, supporting its use as a non-invasive tool for therapeutic monitoring.