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Related Concept Videos

Skin Diseases and Disorders01:23

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Papillary Dermis01:11

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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
04:44

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

Published on: June 16, 2020

Skin involvement in systemic sclerosis.

L Czirják1, I Foeldvari, U Müller-Ladner

  • 1Department of Immunology and Rheumatology, University of Pécs, Pécs, Hungary. laszlo.czirjak@aok.pte.hu

Rheumatology (Oxford, England)
|September 17, 2008
PubMed
Summary
This summary is machine-generated.

Skin thickening in systemic sclerosis (SSc) correlates with disease severity. While the modified Rodnan skin score (mRSS) is standard, new methods like ultrasound and durometry show promise for accurate skin assessment.

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Area of Science:

  • Rheumatology
  • Dermatology
  • Medical Imaging

Background:

  • Skin thickening is a hallmark of systemic sclerosis (SSc), directly correlating with internal organ involvement, prognosis, and disability, particularly in diffuse cutaneous SSc (dcSSc).
  • The modified Rodnan skin score (mRSS) is the established 'gold standard' for assessing dermal thickness but exhibits modest responsiveness in clinical trials and requires specialized training.
  • The need for validated, reproducible, and responsive alternative or parallel methods for measuring skin thickness in SSc is critical for accurate disease monitoring and treatment evaluation.

Purpose of the Study:

  • To evaluate the validity, reproducibility, and responsiveness of alternative methods for measuring skin thickness in systemic sclerosis.
  • To compare the efficacy of ultrasound (US) and mechanical instruments, such as durometry, against the current standard (mRSS).
  • To explore the potential of novel mechanical devices for assessing skin changes in SSc.

Main Methods:

  • Utilized ultrasound (US) with a 20-30 MHz probe for dermal thickness measurement in dcSSc patients.
  • Employed a durometer to measure skin hardness, assessing its inter- and intra-observer reproducibility and sensitivity to change.
  • Compared findings from US and durometry with the modified Rodnan skin score (mRSS) and explored other mechanical instruments (elastometer, twistometer, cutometer, plicometer).

Main Results:

  • Ultrasound (US) measurement of dermal thickness in dcSSc was found to be valid, reproducible, and responsive, though time-consuming and requiring training.
  • Durometry demonstrated good inter- and intra-observer reproducibility and sensitivity to change, correlating well with mRSS and US-measured skin thickness.
  • Several mechanical instruments showed potential in differentiating between involved and non-involved skin, suggesting further research is warranted.

Conclusions:

  • Ultrasound and durometry are valid and reproducible methods for assessing skin thickness in SSc, offering alternatives or complements to mRSS.
  • Durometry presents a promising mechanical method with good correlation to established measures, suitable for clinical evaluation.
  • Further development and validation of mechanical instruments are needed to accurately measure late-stage, irreversible skin damage and atrophy in SSc.