In vivo study of scleroderma by non-invasive techniques

Area of Science:

• Dermatology
• Rheumatology
• Medical Physiology

Background:

• Scleroderma encompasses localized scleroderma (LS) and progressive systemic sclerosis (PSS), both characterized by skin hardening.
• Understanding the distinct pathophysiological changes in the skin of LS and PSS is crucial for effective disease management.

Purpose of the Study:

• To investigate and compare skin thickness, extensibility, transcutaneous oxygen tension (PO2), and cutaneous blood flow in patients with LS and PSS versus healthy controls.
• To identify key non-invasive parameters for monitoring the progression of LS and PSS.

Main Methods:

• Non-invasive techniques were employed to assess skin properties and microcirculation.
• Measurements included skin thickness, skin extensibility, transcutaneous PO2, and cutaneous blood flow.
• Data from 16 LS patients, 11 PSS patients, and normal controls were analyzed.

Main Results:

• Localized scleroderma (LS) exhibited decreased skin extensibility and thickened skin in progressive lesions, alongside increased cutaneous microcirculation and decreased transcutaneous PO2.
• Progressive systemic sclerosis (PSS) showed reduced skin extensibility due to skin thickening, but no significant alterations in cutaneous microcirculation or PO2.
• Skin thickness and extensibility emerged as significant indicators differentiating the conditions.

Conclusions:

• Skin thickness and extensibility are highly valuable non-invasive parameters for assessing the progression of both localized scleroderma and progressive systemic sclerosis.
• Distinct alterations in cutaneous microcirculation and oxygenation are observed in LS but not in PSS, suggesting different underlying mechanisms.