Unbound MEDLINE

Skin involvement in systemic sclerosis.

Abstract

Skin thickening is a characteristic feature of SSc. More extensive skin involvement coincides with more severe internal organ manifestation(s), poor prognosis and increased disability, at least in the early phase of the diffuse cutaneous scleroderma subset. The fully validated, feasible method ('gold standard') for measuring the dermal skin thickness is the modified Rodnan skin score (mRSS). The responsiveness of mRSS was somewhat modest in clinical trials, and a careful teaching process is necessary. Parallel method(s) for measuring skin thickness need to be used in the future. Ultrasound (US) measurement of the dermis with a 20-30 MHz probe is a valid, reproducible and responsive method in patients with dcSSc. However, US is time-consuming and requires a training process. Of the mechanical instruments available, only the durometer, which measures the hardness of skin, has been validated. The inter- and intra-observer reproducibility and sensitivity to change of durometry were good, and correlated with mRSS and US-measured skin thickness. Several further mechanical instruments exist including the elastometer, twistometer, cutometer and plicometer. They seem to distinguish between involved and non-involved skin, and therefore merit further evaluation. The measurement of late-stage, irreversible skin damage/atrophy should be resolved in the future through the development and validation of new instruments.

Links

  • Publisher Full Text
  • Authors

    Czirják L, Foeldvari I, Müller-Ladner U

    Institution

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

    Source

    Rheumatology (Oxford, England) 47 Suppl 5: 2008 Oct pg v44-5

    MeSH

    Biomechanics
    Hardness
    Humans
    Magnetic Resonance Imaging
    Pain Measurement
    Scleroderma, Systemic
    Severity of Illness Index
    Skin

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    18784142