Skin ultrasound in the evaluation of rheumatic diseases: Systemic sclerosis and psoriatic disease

Abstract

The clinical relevance of skin ultrasound evaluation in systemic sclerosis (SSc) and psoriasis (PsO) is significant, as it provides a non-invasive, objective, and reproducible method for assessing skin involvement, which is crucial for diagnosis, monitoring disease progression, and evaluating treatment efficacy. High-frequency ultrasound (HFUS) and shear wave elastography (SWE) are particularly useful in quantifying skin thickness and stiffness, parameters that correlate with disease activity and severity. This approach offers a more sensitive alternative to traditional methods such as the modified Rodnan skin score (mRSS), which can be subjective and variable. This article details the specific clinical applications and benefits of skin ultrasound (US) in SSc and PsO. Although the reviewed studies primarily focus on SSc, the principles of using US for skin evaluation can be extended to PsO. In PsO, US can help assess the extent of skin involvement, monitor treatment response, and potentially differentiate between active and inactive lesions, although specific studies on PsO were not detailed in the analyzed contexts. In contrast to advancements in SSc, the application of skin US in PsO requires further exploration to establish standardized protocols and validate its clinical utility. The potential of US to provide detailed insights into PsO-related skin pathology remains promising, warranting further research to fully understand its benefits. This document presents different US techniques, imaging windows, and technical aspects of performing skin US in SSc and PsO with skin involvement, covering the advantages and limitations of each method in both diseases.