Plicometer skin test: a new technique for the evaluation of cutaneous involvement in systemic sclerosis

Parodi, M.; Castagneto, Corrado; Filaci, Gilberto; Murdaca, Giuseppe; Puppo, Francesco; Indiveri, Francesco; Scudeletti, Marco

doi:10.1093/rheumatology/36.2.244

Cited by 17 publications

(5 citation statements)

References 5 publications

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“…Clinical examination included the mRSS (estimating skin thickness in 17 body areas by palpation), the University of California at Los Angeles (UCLA) skin score (measuring 10 body areas by clinical palpation), the plicometer skin test (using a plicometer to evaluate nine skin areas), and a skin score without any further information. 33 , 62 , 63 …”

Section: Results Of the Systematic Literature Searchmentioning

confidence: 99%

Calcineurin inhibitors in systemic sclerosis – a systematic literature review

Hofmann

Ambühl

Jordan

et al. 2022

Therapeutic Advances in Musculoskeletal

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Objective: To review treatment effectiveness and adverse events of calcineurin inhibitors (CNIs) such as cyclosporin A (CsA) and tacrolimus in patients with systemic sclerosis (SSc). Methods: A systematic literature search was performed on PubMed and Web of Science using the predefined keywords ‘systemic sclerosis’, scleroderma, cyclosporin*, and tacrolimus. Articles were eligible for inclusion, if SSc patients had been treated with CNIs and data on treatment effects were available. Results: This systematic literature review identified 37 papers (19 case reports, 15 case series, 2 controlled studies, and 1 retrospective study) including 134 SSc patients treated with CNIs. In 34 of 37 papers, CsA was used. An improvement of skin fibrosis was observed in 77 of 96 (80.2%) patients using a wide variety of outcome measures and dose regimes. Both controlled studies showed significant improvements, one using a historical control group and one using a no-treatment control group. Improvement in pulmonary function tests (PFTs) occurred in 67.9% (19/28) of the patients who had reduced PFTs at baseline. In 58 (43.3%) cases, adverse renal events were reported, of which 7 (5.2%) were severe such as scleroderma renal crisis (SRC), CsA-associated nephropathy, or death by renal insufficiency. Adverse events led to dose reduction, treatment interruption, or withdrawal in 39 of 134 (29.1%). Conclusion: In this systematic literature review, signals for potential effectiveness of CsA for skin and pulmonary fibrosis were found, but the evidence level of the identified studies was too low to allow robust conclusions. Randomized controlled double-blind trials are needed to conclude on the effectiveness of CNIs in SSc. Renal toxicity of CNIs was confirmed in this review and needs to be considered in the design of such studies.

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Section: Results Of the Systematic Literature Searchmentioning

confidence: 99%

Calcineurin inhibitors in systemic sclerosis – a systematic literature review

Hofmann

Ambühl

Jordan

et al. 2022

Therapeutic Advances in Musculoskeletal

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“…It is generally used to measure the subcutaneous plica in obese patients. Nives Parodi et al [21] demonstrated its use in measurement of skin thickness in SSc patients. They only measured the skin thickness, avoiding capturing the subcutaneous tissue between the arms of the plicometer [21].…”

Section: Plicometrymentioning

confidence: 99%

“…Nives Parodi et al [21] demonstrated its use in measurement of skin thickness in SSc patients. They only measured the skin thickness, avoiding capturing the subcutaneous tissue between the arms of the plicometer [21]. They developed a score from 0 to 3 depending on the thickness of the skin, with plicometer measurement above cut-off for healthy skin was 0, and absence of measurable plica was 3.…”

Section: Plicometrymentioning

confidence: 99%

Methods for objective assessment of skin involvement in systemic sclerosis

Desai,

Chawla,

Larin

et al. 2023

Current Opinion in Rheumatology

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Purpose of review Skin fibrosis is the most prominent disease manifestation of systemic sclerosis (SSc). Although the treatment for other SSc manifestations has expanded over the years, there is limited progress in identifying effective treatment options for SSc skin involvement. This is in part due to limitations in the utilized outcome measures for assessment of skin fibrosis. This review focuses on different emerging assessment tools for SSc skin involvement and their potential use for clinical care and multicenter trials. Recent findings Durometer and other device-based methodologies requiring application of direct pressure to the affected skin have been studied in SSc. However, there are concerns that the required application of pressure might be a source of variability. Ultrasound-based methods have been compared with modified Rodnan Skin Score in several studies, indicating acceptable construct validity. However, few studies have examined their criterion validity by providing comparisons to skin histology. Optical coherence-based methods show promising preliminary results for simultaneous assessment of skin fibrosis and vasculopathy. Further standardization and validation (including comparison to skin histology) of these promising novel assessment tools in large, longitudinal SSc cohort studies are needed to establish them as clinically useful outcome measures with acceptable sensitivity to change. Summary Recent advances in imaging techniques provide a promising opportunity for development of a valid and reliable assessment tool for quantification of SSc skin fibrosis, which can pave the way for approval of effective treatment options for this high burden disease manifestation.

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“…Consequently, efforts are being made to study the disease in its early stages, before overt disease and irreversible organ damage have occurred. Several tools are currently available to assess the disease status, including devices to evaluate skin thickness (i.e., plicometer [13]) and blood flow perfusion (i.e., laser Doppler flowmetry [14]; ultrasound [15]). Thermal infrared (IR) imaging is also employed to evaluate the thermoregulatory finger properties and identify SSc [16].…”

Section: Introductionmentioning

confidence: 99%