LeBlanc N, Falabella A, Murata H, Hasan A, Weiss E, Falanga V
Department of Dermatology, University of Miami School of Medicine, Florida, USA.
Dermatol Surg. 1997 Apr;23(4):285-7. doi: 10.1111/j.1524-4725.1997.tb00046.x.
The degree of skin induration (lipodermatosclerosis) around venous ulcers has prognostic significance; however, objective measurements are needed to assess the induration. The durometer, an engineering instrument used to measure the hardness of metals and plastic, has recently been adapted to assess skin induration.
The purpose of this study was to measure skin induration and its relationship to skin ulceration by the use of a durometer, and to determine the influence of edema, if any, on durometer measurements.
The degree of skin induration on the medial leg was determined in six sequential, nonselected patients with lipodermatosclerosis and leg ulcers, and in five normal volunteers by using a blinded observer's clinical score (0 = normal to 3 = maximal induration) and a hand-held Type 0 durometer. In addition, durometer readings in 14 patients with edema and eight control subjects were taken on the tibia, the dorsum of the foot, and behind the ankle.
Durometer readings in patients with leg ulcers and lipodermatosclerosis diminished as one measured from the superior edge of the ulcer to the knee (r = 0.925). The higher the clinical skin score the higher were the durometer readings (P = 0.0062). The presence of edema did not influence durometer measurements.
The durometer is an effective and reliable instrument for measuring the degree of skin induration in venous ulceration and its readings are not affected by edema. Ulcers occur in skin most affected by lipodermatosclerosis.
静脉性溃疡周围皮肤硬结（脂膜炎性硬化）的程度具有预后意义；然而，需要客观测量来评估硬结情况。硬度计是一种用于测量金属和塑料硬度的工程仪器，最近已被用于评估皮肤硬结。
本研究的目的是使用硬度计测量皮肤硬结及其与皮肤溃疡的关系，并确定水肿（若有）对硬度计测量的影响。
通过盲法观察者的临床评分（0 = 正常至3 = 最大硬结）和手持式0型硬度计，对6例连续入选的患有脂膜炎性硬化和腿部溃疡的患者以及5名正常志愿者测定小腿内侧的皮肤硬结程度。此外，对14例有水肿的患者和8名对照受试者在胫骨、足背和踝关节后方进行硬度计读数测量。
腿部溃疡和脂膜炎性硬化患者的硬度计读数从溃疡上缘至膝盖测量时逐渐降低（r = 0.925）。临床皮肤评分越高，硬度计读数越高（P = 0.0062）。水肿的存在不影响硬度计测量。
硬度计是测量静脉性溃疡皮肤硬结程度的有效且可靠的仪器，其读数不受水肿影响。溃疡发生在受脂膜炎性硬化影响最严重的皮肤部位。
