Multiparametric Ultrasound Assessment of Alopecia Areata Plaque with Atrophy After Serial Corticosteroid Infusion

Abstract

Introduction: This study explores the use of multiparametric ultrasound (MPUS) to evaluate a case of alopecia areata (AA) with scalp atrophy resulting from repeated corticosteroid injections. AA is a non-scarring, autoimmune alopecia characterized by lymphocytic infiltration near the hair follicle bulb, causing hair loss. Excessive corticosteroid use can lead to tissue atrophy and impaired hair growth. The patient, a 27-year-old woman, presented with a resistant scalp lesion following multiple corticosteroid injections.
Perspectives: The MPUS examination combined B-mode imaging, Doppler ultrasound, and shear wave elastography. B-mode imaging revealed scalp thinning (2.4 mm vs. 4.9-5.0 mm in adjacent areas), while Doppler showed reduced vascular density and tortuous vessels with a peak systolic velocity of 3.5 cm/s (normal: 5.5 cm/s). Elastography indicated increased tissue stiffness in the reticular dermis and hypodermis compared to surrounding areas. The study concludes that MPUS is an effective non-invasive diagnostic tool, providing anatomical and functional insights into scalp conditions, thus offering an alternative to biopsy for monitoring therapeutic outcomes.