Quantitative assessment of scleroderma by surface wave technique

Scleroderma is a multisystem disease characterized by cutaneous and visceral fibrosis. Skin disease is both a disabling feature of scleroderma and a predictor of visceral involvement. The established method of skin assessment is the modified Rodnan skin score (MRSS) which uses semi-quantitative manual skin scoring. However, the Rodnan method is subjective. We have developed a technique and system for assessing skin health by producing and analyzing surface waves in the skin to determine the skin viscoelastic properties. Viscoelasticity of human skin is measured on 30 healthy volunteers and 10 scleroderma patients at six anatomic sites. A small force, monitored by a force transducer, is applied to the skin using a ball-tipped device attached to a mechanical shaker. The skin motion is measured by a scanning laser vibrometer. The surface wave speed is measured by the phase gradient method. The viscoelasticity is inversely estimated by the wave speed dispersion. A typical measurement of the surface wave speed is 3.25±0.19 m/s on the forearm of a volunteer at 200 Hz. With the wave speed dispersion from 100 Hz to 400 Hz, the shear elasticity μ(1) and shear viscosity μ(2) are estimated, respectively, 7.86±1.86 kPa and 5.03±0.60 Pa on the forearm. Statistical analyses suggest that there are significant differences of viscoelasticity between scleroderma patients and healthy subjects. Scleroderma can be effectively and quantitatively evaluated based on human skin viscoelasticity.