Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine (Di.M.I.), IRCCS San Martino Polyclinic Hospital, University of Genova, Genoa, Italy.
Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine (Di.M.I.), IRCCS San Martino Polyclinic Hospital, University of Genova, Genoa, Italy.
Microvasc Res. 2019 Sep;125:103874. doi: 10.1016/j.mvr.2019.04.004. Epub 2019 Apr 8.
The aim of this study was to identify any correlations between microvascular damage, assessed by nailfold videocapillaroscopy and skin impairment, evaluated by three different methods, the modified Rodnan skin score (mRSS), skin high-frequency ultrasound (US) and the plicometer skin test (PST) in systemic sclerosis (SSc) patients.
Sixty-three SSc patients and 63 healthy subjects were enrolled. Nailfold videocapillaroscopy (NVC) was used to assess the nailfold capillaroscopy pattern ("Early", "Active" or "Late"), according to the Cutolo classification. All subjects were assessed by mRSS, US and PST to evaluate their dermal thickness (DT) in the seventeen skin areas of the body usually evaluated by mRSS (zygoma, fingers, hands, dorsum of hands, forearms, arms, chest, abdomen, thighs, legs, feet). Statistical evaluation was performed by nonparametric tests.
All the three methods demonstrated progressively higher values of skin impairment in patients with "Early", "Active" or "Late" pattern of nailfold microangiopathy (for mRSS p < 0.01, US p < 0.02 and PST p < 0.02). A positive correlation was also observed in SSc patients between the three methods used to evaluate skin involvement (mRSS vs US, mRSS vs PST, PST vs US, p < 0.0001 respectively).
This study demonstrates that there is a correlation between two of the most important aspects to classify and monitor the SSc patients, i.e. microvascular damage progression (evaluated by NVC) and skin damage (assessed by mRss, US and PST).
本研究旨在确定甲襞微血管损伤（通过甲襞毛细血管镜评估）与皮肤损伤（通过三种不同方法评估，即改良罗德纳皮肤评分（mRSS）、皮肤高频超声（US）和皮褶计皮肤测试（PST））之间的任何相关性，在系统性硬化症（SSc）患者中。
纳入 63 例 SSc 患者和 63 例健康对照者。使用甲襞毛细血管镜（NVC）评估指甲襞毛细血管镜模式（“早期”、“活跃”或“晚期”），根据 Cutolo 分类。所有受试者均接受 mRSS、US 和 PST 评估，以评估其在身体 17 个通常用 mRSS 评估的皮肤区域的皮肤厚度（DT）（颧骨、手指、手、手背、前臂、手臂、胸部、腹部、大腿、腿、脚）。统计评估采用非参数检验。
所有三种方法均显示指甲襞微血管病变呈“早期”、“活跃”或“晚期”模式的患者皮肤损伤程度逐渐增加（mRSS 差异有统计学意义，p<0.01，US 差异有统计学意义，p<0.02，PST 差异有统计学意义，p<0.02）。SSc 患者还观察到三种用于评估皮肤受累的方法之间存在正相关（mRSS 与 US、mRSS 与 PST、PST 与 US，p<0.0001）。
本研究表明，在分类和监测 SSc 患者的两个最重要方面之间存在相关性，即微血管损伤进展（通过 NVC 评估）和皮肤损伤（通过 mRSS、US 和 PST 评估）。
