Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialities, University of Genova, IRCCS Policlinico San Martino, Genova, Italy.
Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialities, University of Genova, IRCCS Policlinico San Martino, Genova, Italy.
Microvasc Res. 2018 Jan;115:28-33. doi: 10.1016/j.mvr.2017.08.004. Epub 2017 Aug 20.
To identify possible correlations between skin blood perfusion (BP) and dermal thickness (DT) in different skin areas of systemic sclerosis (SSc) patients.
Sixty-two SSc patients, according to 2013 EULAR/ACR criteria, and 62 healthy subjects (CNT) were enrolled. Skin BP was analysed by laser speckle contrast analysis (LASCA) at the level of dorsum of the middle phalanx of the third fingers, dorsal aspect of the hands and zygoma. DT was assessed by both skin high frequency ultrasound (US) and modified Rodnan skin score (mRSS) in the same above reported areas. All patients were studied also by nailfold videocapillaroscopy (NVC) to assess the proper pattern of microvascular damage ("Early", "Active", or "Late").
At the level of finger dorsum a statistically significant negative correlation was observed in SSc patients between skin BP and both ultrasound-DT (p=0.0005 r=0.43) and mRSS (p=0.0007 r=0.42), but not at the level of hand dorsum and zygoma. No statistically significant correlation was present between skin BP and ultrasound-DT at any level in CNT. In detail, SSc patients, compared to CNT, showed a statistically significant lower BP only at level of fingers (median PU 72.6 vs 136.1 respectively, p<0.0001) and a statistically significant higher ultrasound-DT at the level of dorsum of 3th finger bilaterally (median mm 0.9 vs 0.7, p<0.0001), dorsum of hands (median mm 0.9 vs 0.7, p<0.0001) and zygoma (median mm 0.8 vs 0.7, p<0.0001). A significant positive correlation between ultrasound-DT and mRSS was observed in SSc patients at level of the three areas (dorsum of fingers p<0.0001 r=0.51; dorsum of hands p=0.03 r=0.27; zygoma p=0.0001 r=0.45). A progressive decrease of skin BP and increase of ultrasound-DT was found correlated with the progression of the severity of NVC patterns.
This study demonstrates for the first time in SSc patients a significant inverse relationship between skin BP, measured by LASCA, and DT, evaluated by both US and mRSS, at the level of dorsum of the middle phalanx of the third fingers.
确定系统性硬化症（SSc）患者不同皮肤区域的皮肤血流灌注（BP）和真皮厚度（DT）之间可能存在的相关性。
根据 2013 年 EULAR/ACR 标准，纳入 62 名 SSc 患者和 62 名健康对照者（CNT）。在第三指中节背侧、手背和颧骨处，采用激光散斑对比分析（LASCA）分析皮肤 BP。在上述相同部位，采用皮肤高频超声（US）和改良 Rodnan 皮肤评分（mRSS）评估 DT。所有患者还接受甲襞视频毛细血管镜（NVC）检查，以评估微血管损伤的适当模式（“早期”、“活跃”或“晚期”）。
在手指背侧，SSc 患者的皮肤 BP 与超声-DT（p=0.0005 r=0.43）和 mRSS（p=0.0007 r=0.42）呈统计学显著负相关，但在手背和颧骨处无统计学显著相关性。在 CNT 中，皮肤 BP 与超声-DT 在任何水平均无统计学显著相关性。具体而言，与 CNT 相比，SSc 患者仅在手指水平显示出统计学显著较低的 BP（中位数 PU 分别为 72.6 和 136.1，p<0.0001），并且双侧第 3 指背侧、手背和颧骨处的超声-DT 统计学显著升高（中位数分别为 0.9 和 0.7，mm，p<0.0001）。在 SSc 患者中，超声-DT 与 mRSS 在三个区域（手指背侧 p<0.0001 r=0.51；手背 p=0.03 r=0.27；颧骨 p=0.0001 r=0.45）之间呈显著正相关。皮肤 BP 的逐渐降低和超声-DT 的增加与 NVC 模式严重程度的进展相关。
本研究首次在 SSc 患者中证明，在第三指中节背侧，LASCA 测量的皮肤 BP 与 US 和 mRSS 评估的皮肤 DT 之间存在显著的负相关关系。
