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High frequency ultrasound measurement of digital dermal thickness in systemic sclerosis
  1. Olga Kaloudi1,*,
  2. Francesca Bandinelli1,
  3. Emilio Filippucci2,
  4. Maria Letizia Conforti1,
  5. Irene Miniati1,
  6. Serena Guiducci1,
  7. Francesco Porta1,
  8. Antonio Candelieri3,
  9. Domenico Conforti3,
  10. Genesio Grassiri4,
  11. Walter Grassi2,
  12. Marco Matucci Cerinic1
  1. 1 Department of Biomedicine,Division of Rheumatology AOUC, Centre Denothe, University of Florence, Italy;
  2. 2 Division of Rheumatology, University of Marche, Jesi, Ancona, Italy;
  3. 3 Laboratory of Decision Engineering for Health Care Delivery,University of Calabria, Cosenza, Italy;
  4. 4 Esaote spa, Italy
  1. 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}


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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