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. 2021 Feb 16;101(2):adv00395.
doi: 10.2340/00015555-3747.

Assessment of Sclerodermoid Chronic Graft-versus-host Disease with Colour Doppler Ultrasound

Priscila Giavedoni  1 , Carmen Martinez, Sebastian Podlipnik, María Suárez-Lleidó, Ignasi Martí-Martí, Daniel Morgado-Carrasco, Montserrat Rovira, Francesc Fernández-Avilés, Gonzalo Gutiérrez, Laura Rosiñol, Joan Cid, Miquel Lozano, José Manuel Mascaró Jr
Affiliations

Assessment of Sclerodermoid Chronic Graft-versus-host Disease with Colour Doppler Ultrasound

Priscila Giavedoni et al. Acta Derm Venereol. .

Abstract

Sclerodermoid chronic graft-versus-host disease (scGVHD) is a severe complication of allogeneic haema-- topoietic stem cell transplantation. The aim of this study was to investigate the usefulness of high-frequency ultrasound of the skin in assessing the inflammatory patterns and prognosis of patients with scGVHD. A prospective study was carried out with patients who developed scGVHD in the period June 2016 to April 2018. Clinical and ultrasound examinations were performed on the first visit and at 6-month follow-up. A total of 24 patients were included in the study. A 6-month follow-up high-frequency ultrasound of the skin was performed on 20 of the 24 patients. Abnormal B-mode findings in high-frequency ultrasound of the skin consisted of hypoechogenic dermis, hypoechogenicity of septa and hyperechogenicity of lobules in hypodermis. No differences were observed in these basal parameters between treatment progressive/non-responding and inactive/responding scGVHD groups of patients. Basal Doppler showing increased vascular flow with a systolic peak ≥10 cm/s and a vascular resistance index ≥ 0.70 was observed only in those patients who developed progressive/non-responding scGVHD (62.5% vs 0% p = 0.006). In conclusion, Doppler ultrasound is a useful tool to assess the inflammatory activity and outcome of scGVHD. These findings could enhance patient management and help to guide treatment decisions.

Keywords: Doppler ultrasound; allogeneic haematopoietic stem cell transplantation; diagnosis; inflammation; sclerodermoid; graft-versus-host disease.

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Conflict of interest statement

The authors have no conflicts of interest to declare

Figures

Fig. 1
Fig. 1
High-frequency ultrasound of normal skin. The upper image shows hypoechogenicity of the dermis, loss of dermo-hypodermal differentiation, increased hypoechogenicity and thickness of the septa, with hyperechogenicity of the lobules. The lower image shows the increased flow in color Doppler mode.
Fig. 2
Fig. 2
Clinical status of patients and Doppler ultrasound (DU) findings at the beginning of the study and at 6 months of follow-up. DU+: Doppler ultrasound positive (systolic peaks ≥ 10 cm/s and vascular resistance index ≥ 0.70 hertz). DU– : Doppler ultrasound negative (systolic peaks <10 cm/s and vascular resistance index < 0.70 hertz).
Fig. 3
Fig. 3
High-frequency ultrasound of skin in a patient with sclerodermoid chronic graft-versus-host-disease (scGVHD). Upper image: B-mode; lower image.
See this image and copyright information in PMC

References

    1. Lee SJ, Flowers MED. Recognizing and managing chronic graft-versus-host disease. Hematol Am Soc Hematol Educ Program 2008; 1: 134–141. - PubMed
    1. Cowen EW. Graft-vs-host disease. JAMA Dermatol 2016; 152: 356. - PubMed
    1. Arai S, Jagasia M, Storer B, Chai X, Pidala J, Cutler C, et al. Global and organ-specific chronic graft-versus-host disease severity according to the 2005 NIH Consensus Criteria. Blood 2011; 118: 4242–4249. - PMC - PubMed
    1. Jagasia MH, Greinix HT, Arora M, Williams, K, Wolff D, Cowen E, et al. National Institutes of Health Consensus Development Project on criteria for clinical trials in chronic graft-versus-host disease: I. The 2014 Diagnosis and Staging Working Group report. Biol Blood Marrow Transplant J Am Soc Blood Marrow Transplant 2015; 21: 389–401.e1. - PMC - PubMed
    1. Wortsman X. Ultrasound in dermatology: why, how, and when? Semin Ultrasound CT MR 2013; 34: 177–195. - PubMed

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