A preliminary study on ultrasound techniques applied to cicatricial alopecia
Zeynep Gizem Kaya İslamoğlu  Emine Uysal
First published: 29 May 2019 https://doi.org/10.1111/srt.12725
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Abstract
Background
Cicatricial alopecia (CA) is a group of disorder characterized by permanent destruction of the hair follicle. Shear wave elastography (SWE) and superb microvascular imaging (SMI) are noninvasive ultrasonic techniques which evaluate thickness, stiffness, and vascular index of tissues.

Objectives
This study explored the ranges of cicatricial alopecia area and normal scalp with a combined modality of SMI and SWE and investigated the feasibility of their use in assessing these diseases.

Methods
Seventeen patients diagnosed with CA and twenty healthy controls were included in the study. SWE and SMI were performed with an Aplio 500 ultrasound system.

Results
The mean age of patient group was 37.00 ± 13.16, and the mean age of the healthy controls were 36.00 ± 11.79. SWE results as m/s in cicatricial plaques (urn:x-wiley:0909752X:media:srt12725:srt12725-math-0001 = 5191) were higher than non‐alopecic scalp areas (urn:x-wiley:0909752X:media:srt12725:srt12725-math-0002 = 4460) in patient group (t (16) = 2260; P = 0.038 < 0.05). SMI values in patient group (cicatricial plaques) (urn:x-wiley:0909752X:media:srt12725:srt12725-math-0003 = 1200) were significantly higher than control group SMI values (urn:x-wiley:0909752X:media:srt12725:srt12725-math-0004 = 0.005) (t (35) = 3.075; P = 0.012 < 0.05).

Conclusions
To the best of our knowledge, this is the first study to evaluate SWE and SMI scores in cicatricial alopecia. We found higher stiffness and vascularity in patient group. We conclude that SWE and SMI can show fibrosis and inflammation like previous studies. Especially, SWE as m/s is more sensitive than as kPa for cicatricial alopecia.