Background The modified Rodnan skin score (mRSS) analyzes the extent and severity of skin thickening of Systemic Sclerosis (SSc) by palpation in 17 anatomical sites. It is graded by a scale 0-3, where 0 = normal skin, 1 = mild skin thickening, 2 = moderate 3 = skin thickening and skin thickening with intense inability to pucker the skin.1 Studies have shown that diffuse SSc have higher mRSS and this may compromise the rates of morbidity and mortality in these patients.2 However, there is no consensus on a cutoff point that confirms mRSS as an independent marker of activity and severity disease; furthermore, the subjectivity in the evaluation and disease staging and therapeutic response-related variability impair its accuracy and reprodutibility.3
Objectives To evaluate the correlation between skin thickening and disorders mood, quality of life and disability aspects in a group with diffuse and limited SSc patients.
Methods Cross-sectional study with 59 SSc patients, followed-up at the Walter Cantidio University Hospital. The skin thickening was analyzed by mRSS; the disorders mood and quality of life by SRQ-20 and SF-36 questionnaires; and disability by HAQ. Mann-Whitney test was carried out to compare the scales of the diffuse and limited groups, and the Spearman test to correlate mRSS with the other scales. The significance level was stipulated in 5%.
Results In that sample, 47 patients had the diffuse form (79%). The mean and standard deviation of mRSS was 20 (±8.7); of positives responses SRQ-20 8,9 (±4.9); of functional capacity, physical aspect and health general status, respectively, were 42.5 (±21.5), 26.5 (±35.9) and 38.3 (±20.1); of HAQ was 1.10 (±0.7). The mRSS correlated negatively with SRQ-20 (-0.2) and positively with HAQ (-0.2). When compared the diffuse and limited forms, the worse mRSS was the first one (21.9±8.5), P=0.00; in this group, mRSS correlated stronger negatively with SRQ-20 (-0.32; P=0.027) and positively with HAQ (-0.31; P=0.033).
Conclusions It was confirmed that exist SSs related-disorders mood tendency, quality of life decrease and disability. The diffuse form showed the highest degree of skin thickening and that seemed to determine worsening of emotional and functional aspects.
Sampaio-Barros PD, Bortoluzzo AB, Marangoni RGJ, Rheumatol.
Merkel PA, Silliman NP, Clements PJ, Arthritis Rheum
Hasegawa M, Asano Y, Endo H, Rheumatology (Oxford)
Disclosure of Interest None declared