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

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

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.

MeSH terms

  • Chronic Disease
  • Graft vs Host Disease* / diagnostic imaging
  • Graft vs Host Disease* / etiology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Prospective Studies
  • Stem Cell Transplantation
  • Ultrasonography, Doppler, Color