Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Systemic sclerosis (SSc) is characterized by increase of dermal thickness (DT) and impairment of microvascular system (1). Several studies demonstrate that nailfold capillaroscopy (NVC) patterns of microangiopathy correlate with organ involvement, but few studies investigated the correlation between nailfold microangiopathy and skin involvement. The modified Rodnan skin score (mRss) is the validated method to assess the severity of skin damage (2,3), high frequency skin ultrasound (US) is able to detect skin damage in SSc (4,5), and the plicometer skin test (Plicometry) is a further method to evaluate cutaneous involvement in SSc patients (6). The aim of this study was to identify possible correlations between different patterns of nailfold microangiopathy and three different methods (mRss, US and Plicometry) to assess DT in SSc patients.
Methods: Sixty-three SSc patients (ACR/EULAR criteria) (mean age 64±11SD years, mean disease duration 7±6 years, 43 lcSSc and 20 dcSSc) and 63 sex and age matched healthy subjects were enrolled, after written informed consent. All subjects were assessed by mRss, US and Plicometry to evaluate DT in the seventeen skin areas of the body usually evaluated by mRss (zygoma, fingers, dorsum of hands, forearms, upper arms, chest, abdomen, thighs, legs, feet) (1-6). NVC was performed to assess the proper pattern of microangiopathy (“Early”, “Active” or “Late” pattern) and to calculate the microangiopathy evolution score (MES) (7-8). Statistical evaluation was performed by non-parametric tests.
Results: There was a statistically significant positive correlation between DT values and severity of nailfold microangiopathy: all methods detected a progressively higher DT in patients with “Early”, “Active” and “Late” pattern of microangiopathy (p<0.005), and a positive correlation was observed also with MES (r=0.71 p<0.001). Finally, a positive correlation was observed in SSc patients between the three method to evaluate DT (Plicometry vs mRss r=0.98, p<0.0001; Plicometry vs US r=0.53, p<0.0001; US vs mRss r=0.53, p<0.0001). As expected, the group of SSc patients had a statistically significant higher DT at level of all areas, as evaluated by the three methods, when compared to the control group (p<0.0001).
Conclusion: This study demonstrates a relationship between skin damage and microangiopathy impairment in SSc patients, as well as a correlation between different methods to assess DT.
References. 1. Moore TL, et al. Rheumatology 2003;42:1559-63. 2. Sulli A, et al. Ann Rheum Dis. 2014;69:1140-3. 3. Kaldas M, et al. Rheumatology 2009;48:1143-6. 4. Hesselstrand R, et al. Rheumatology 2008;47:84-7. 5. Kaloudi O, et al. Ann Rheum Dis.2010;69:1140-3. 6. Parodi MN, et al. Br JRheumatol. 1997;36:244-50. 7. Sulli A, et al. Ann Rheum Dis 2008;67:885-7. 8. Cutolo et al. J Rheumatol 2000; 27;155.60.
To cite this abstract in AMA style:Ruaro B, Sulli A, Pizzorni C, Alessandri E, Paolino S, Ghio M, Tomatis V, Smith V, Cutolo M. Correlation between Capillaroscopic Patterns of Nailfold Microangiopathy and Three Different Methods to Assess Dermal Thickness in Systemic Sclerosis Patients [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). http://acrabstracts.org/abstract/correlation-between-capillaroscopic-patterns-of-nailfold-microangiopathy-and-three-different-methods-to-assess-dermal-thickness-in-systemic-sclerosis-patients/. Accessed February 21, 2018.
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