Reduced skin thickness: a new minor diagnostic criterion for the classical and hypermobility types of Ehlers-Danlos syndrome

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Reduced skin thickness: a new minor diagnostic criterion for the classical

and hypermobility types of Ehlers-Danlos syndrome

C. Eisenbeiss, A. ez*, M. Hagedorn-Greiwe, D.P. Reinhardt, B. Bätge§

and J. Brinckmann

British Journal of Dermatology

Volume 149 Issue 4 Page 850 - October 2003

Summary

Background

The diagnosis of Ehlers-Danlos syndrome (EDS) is mainly based on clinical

criteria, although in some instances a sound molecular diagnosis is

available. Clinical signs can be divided into two categories: one with high

diagnostic specificity and the other with low specificity. Despite the fact

that reduced skin thickness is one of the dermatological features in

patients with EDS, this issue has not been analysed in greater detail.

Objectives

To determine skin thickness in patients with the classical and the

hypermobility types of EDS.

Methods

In 21 patients with classical type of EDS and in nine patients with

hypermobility type of EDS, skin thickness was analysed at different body

sites by cross-sectional b-mode scans obtained with a 20-MHz ultrasound

system.

Results

We found a significant decrease in skin thickness in both types of EDS,

which was highest at the chest and at the distal part of the lower leg.

Conclusions We propose that the reduced thickness of the dermis as

determined by high-resolution 20-MHz ultrasound can be used as a new minor

criterion in the diagnosis of the classical and the hypermobility types of

EDS.