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Abstract Number: 1701

Can Durometer Differentiate Limited Versus Diffuse Cutaneous Systemic Sclerosis?

Vivek Nagaraja1, Amber Young1, Veronica J. Berrocal2 and Dinesh Khanna1, 1Department of Medicine, University of Michigan Scleroderma Program, Ann Arbor, MI, 2Department of Biostatistics- School of Public Health, University of Michigan, Ann Arbor, MI

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: skin fibrosis and systemic sclerosis

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Session Information

Date: Monday, November 6, 2017

Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's – Clinical Aspects and Therapeutics Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: The durometer is a handheld device that measures the hardness of a surface. It has been used to measure skin hardness in patients with diffuse cutaneous systemic sclerosis (dcSSc), and was found to be feasible, reliable, and responsive to change in a trial and US cohort [1, 2]. The objective of this study is to assess if durometer can differentiate skin hardness in patients with limited cutaneous SSc (lcSSc) vs. dcSSc.

Methods: This is a single center cross-sectional study. Durometer assessment was performed at two areas – forearm and thigh by same observer. At each of these areas, three values were assessed and a median score was reported separately for each area. We assessed the correlation between durometer and mRSS at the forearm and thigh using the Pearson’s correlation coefficient. Paired t-test was used to assess the difference in the mean durometer scores between sub-groups (with p-value less than 0.05).

Results: A total of 45 patients participated in this study – healthy controls (N=21), dcSSc (N=14), and lcSSc (N=10). Majority of patients were females across the groups (dcSSc 64%, lcSSc 80%, HC 76%). The mean (SD) durometer reading of 3 groups were: at the forearm, 19.22 for HC, 24.28 for lcSSc, and 34.53 for dcSSc; at the thigh, 19.39 for HC, 28.68 for lcSSc, and 31.04 for dcSSc. The mean [SD] overall mRSS was 3.89[2.47] in lcSSc and 16.38[7.5] in dcSSc. We found statistically significant correlations in the forearm measurements between median durometer scores and mRSS in dcSSc (0.56, p<0.05), but not in lcSSc (0.36, p=0.34). Durometer was able to differentiate lcSSc from dcSSc (median durometer scores 34.53 units vs. 24.28 units for lcSSc, p=0.006) but not in the thigh (median durometer scores 31.04 units vs. 28.68 units for lcSSc, p=0.53; Table).

Conclusion: Durometer was able to differentiate skin hardness in dcSSC vs lcSSc patients when measured in the forearm.


Table: Mean [SD] durometer scores between the groups

Location

Mean Durometer Scores

p-value

HC

dcSSc

lcSSc

Forearm

19.22 [2.75]

34.53 [7.88]

<0.001

19.22 [2.75]

24.28 [8.19]

<0.09

34.53 [7.88]

24.28 [8.19]

0.006

Thigh

19.39 [3.64]

31.04 [8.28]

<0.001

19.39 [3.64]

28.68 [9.24]

0.01

31.04 [8.28]

28.68 [9.24]

0.53

HC – healthy controls; DcSSc – diffuse cutaneous systemic sclerosis; LcSSc – limited cutaneous systemic sclerosis

References:

1. Merkel PA, Silliman NP, Denton CP, Furst DE, Khanna D, Emery P, et al. Validity, reliability, and feasibility of durometer measurements of scleroderma skin disease in a multicenter treatment trial. Arthritis Rheum. 2008 May 15; 59(5):699-705.

2. Wiese AB, Berrocal VJ, Furst DE, Seibold JR, Merkel PA, Mayes MD, et al. Correlates and responsiveness to change of measures of skin and musculoskeletal disease in early diffuse systemic sclerosis. Arthritis Care Res (Hoboken). 2014 Nov; 66(11):1731-1739.


Disclosure: V. Nagaraja, None; A. Young, None; V. J. Berrocal, None; D. Khanna, None.

To cite this abstract in AMA style:

Nagaraja V, Young A, Berrocal VJ, Khanna D. Can Durometer Differentiate Limited Versus Diffuse Cutaneous Systemic Sclerosis? [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/can-durometer-differentiate-limited-versus-diffuse-cutaneous-systemic-sclerosis/. Accessed .
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