Correlation between elastosonography and nailfold microvascular alterations in systemic sclerosis patients.

Area of Science:

• Rheumatology
• Dermatology
• Medical Imaging

Background:

• Systemic sclerosis (SSc) is characterized by vascular damage and fibrosis.
• Peripheral microangiopathy, detectable by nailfold videocapillaroscopy (NVC), is an early sign.
• Ultrasound real-time elastosonography (US-RTE) shows potential for assessing skin elasticity reduction.

Purpose of the Study:

• To investigate correlations between NVC-detected microvascular alterations and finger tissue stiffness in SSc patients.
• To evaluate the utility of US-RTE in quantifying skin stiffness in SSc.
• To explore the relationship between vascular changes and fibrotic processes in SSc.

Main Methods:

• Twenty SSc patients (16 female, 4 male) meeting ACR criteria were recruited.
• All participants underwent clinical examination, NVC, and US-RTE of the fingers.
• US-RTE measured skin stiffness on the palmar surface of distal phalanges.

Main Results:

• Diffuse disease subset (DSS) patients exhibited significantly higher skin stiffness than limited disease subset (LSS) and healthy subjects.
• A significant association was found between a 'Late' NVC pattern and increased skin stiffness.
• Multiple regression analysis confirmed an independent link between late NVC patterns and skin stiffness (R2=0.24, p=0.027).

Conclusions:

• This study establishes a significant relationship between microvascular alterations and skin stiffness in SSc.
• US-RTE is a valuable tool for assessing skin stiffness in SSc patients.
• Findings highlight the interconnectedness of vascular and fibrotic changes in SSc pathophysiology.