Abstract: 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.

Eisenbeiss C, ez A, Hagedorn-Greiwe M, Reinhardt DP, Batge B,

Brinckmann J.

Department of Dermatology, University of Lubeck, 23538 Lubeck, Germany.

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.