Concise report
High frequency ultrasound measurement of digital dermal thickness in systemic sclerosis
1 Department of Biomedicine,Division of Rheumatology AOUC, Centre Denothe, University of Florence, Italy;
2 Division of Rheumatology, University of Marche, Jesi, Ancona, Italy;
3 Laboratory of Decision Engineering for Health Care Delivery,University of Calabria, Cosenza, Italy;
4 Esaote spa, Italy
Correspondence to: olga kaloudi, Department of Biomedicine,Division of Rheumatology AOUC, Centre Denothe, University of Florence, Flo, Villa Monna Tessa, Viale Pieraccini 18, Florence, 50139, Italy; olgakaloudi{at}hotmail.com
Accepted 17 August 2009
Background: Currently, the assessment of dermal thickness in Systemic Sclerosis (SSc) is performed by palpation with the modified Rodnan Skin Score (mRSS).
Objective: To verify if high frequency ultrasound (US) may be a reliable and a reproducible method to measure digital dermal thickness.
Methods: In 70 SSc patients, skin thickness was evaluated with US by two observers in two different sites of the second digit of the dominant limb to determine the inter-observer variability. Patients and controls were examined twice by the first observer for intra-observer variability. Patients were divided into three subgroups according to the phase of the disease (oedematous, fibrotic and atrophic).
Results: At both examined areas, US showed a significant dermal thickening (p<0,001) in the whole group of SSc patients. A low intra- and inter-observer variability was found. A highly significant correlation between the global mRSS and the local dermal thickness at the two examined sites (p:0.032 and p:0.021) was detected. Skin thickness resulted significantly higher in the oedematous than in the fibrotic group (p<0.001) and significantly higher in the fibrotic and the oedematous group (p<0.001) than in the atrophic group (p<0.002).
Conclusions: US is a reliable and reproducible tool, able to detect digital dermal thickening in SSc.
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