Systemic sclerosis: an ultrasonographic study of skin and subcutaneous tissue in relation to clinical findings

BACKGROUND: Skin thickening and tightness are characteristic manifestations of systemic sclerosis (SSc) and the only major diagnostic criterion. The aim of this study is to compare the results of high frequency ultrasound of skin and subcutaneous tissue (SC) in SSc patients and healthy control subjects and also to correlate our patients†US findings with the severity score and with different clinical parameters. METHODS: Skin thickness and subcutaneous thickness were measured by high frequency (12-5 MHz) ultrasound at five different anatomical sites in 40 patients with SSc and 40 healthy control subjects. Results were compared with modified Rodnan skin score (mRss), with the severity score and with different clinical parameters. RESULTS: Patients with SSc had thicker skin than control subjects. Ultrasound measurements correlated with the mRss as well as the severity score of the disease. The degree of skin thickening tended to diminish with longer disease duration. Also, SSc patients had thinner SC fat thickness than control subjects. CONCLUSION: Ultrasound technique is a reliable noninvasive tool that gives reproducible results for the evaluation of skin and SC tissue involvement in SSc patients, adding a separate dimension to the assessment of disease severity and may be used to identify different phases of skin involvement.