Falanga V, Bucalo B
Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL 33101.
J Am Acad Dermatol. 1993 Jul;29(1):47-51. doi: 10.1016/0190-9622(93)70150-r.
Skin induration is difficult to quantify. In patients with systemic sclerosis (scleroderma), a clinical skin severity score (0 = normal skin; 3 = maximal induration) has been in use for several years for assessment of skin involvement and therapeutic outcome.
The purpose of this study was to find a more objective method to assess skin hardness in patients with scleroderma.
Finger pads, forearms, and thighs of 12 sequential nonselected patients with scleroderma and eight normal control subjects were scored by an observer blinded as to group, and quadruplicate determinations of the degree of skin induration at these anatomic sites were made with a hand-held type O durometer.
Consistently, these anatomic sites except for the forehead showed a direct relation between the skin severity score and the hardness measured with the durometer. The best results were obtained from the index finger pad where, compared with uninvolved skin, an increased skin severity score was associated with higher durometer readings (p = 0.0032, p = 0.0002, and p = 0.0005 for skin scores of 1, 2, and 3, respectively).
The durometer is an effective and reliable method to assess skin hardness.
皮肤硬结难以量化。在系统性硬化症（硬皮病）患者中，临床皮肤严重程度评分（0 = 正常皮肤；3 = 最大硬结）已使用数年，用于评估皮肤受累情况和治疗效果。
本研究的目的是找到一种更客观的方法来评估硬皮病患者的皮肤硬度。
对12例连续入选的非选择性硬皮病患者和8名正常对照者的指腹、前臂和大腿进行评分，评分者对分组情况不知情，并使用手持式O型硬度计对这些解剖部位的皮肤硬结程度进行四次重复测定。
一直以来，除额头外，这些解剖部位的皮肤严重程度评分与用硬度计测量的硬度之间呈直接关系。从食指腹获得的结果最佳，与未受累皮肤相比，皮肤严重程度评分增加与硬度计读数升高相关（皮肤评分为1、2和3时，p分别为0.0032、0.0002和0.0005）。
硬度计是评估皮肤硬度的一种有效且可靠的方法。
