A new study has compared results of the modified Rodnan skin score (mRSS), durometry, and ultra-high-frequency ultrasound (UHFUS) in patients with systemic sclerosis (SSc) and healthy controls.

The study, published in Diagnostics, found no correlations between UHFUS and mRSS or durometry, but patients with SSc had UHFUS results that were distinct from healthy controls.

“Recently, cutaneous ultrasonography emerged as a remarkable technique which allows for quantifying skin thickness, and studies regarding its use in SSc skin assessment have been published so far,” the authors wrote. “Our work aims to assess cutaneous involvement in a cohort of SSc patients, comparing results obtained from mRSS, durometry and UHFUS to obtain a complete and accurate multiparametric non-invasive evaluation of SSc skin.”

The research team enrolled 47 patients with SSc and 15 healthy age- and sex-matched controls at a single center in Italy between January and December 2019. All participants underwent a rheumatological, dermatological, and radiological examination on enrollment. mRSS, durometry, and UHFUS were also performed and the outcomes compared.

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The results of UHFUS revealed that epidermal thickness was inversely correlated with the duration of the disease, which concurs with other studies showing that patients with short-term SSc had high skin thickness and low echogenicity.

There were a lack of correlations between UHFUS and either mRSS or durometry, but there were distinct results obtained with UHFUS between patients and controls. The authors speculate that this is because the techniques are complementary rather than equivalent. For example, mRSS has been shown to reliably assess hardness, and UHFUS reveals specific skin characteristics such as thickness and echogenicity.

The authors conclude that UHFUS is a complementary noninvasive diagnostic tool for skin assessment in patients with SSc and suggest that future clinical applications in this context could be useful.


Di Battista M, Barsotti S, Vitali S, et al. Multiparametric skin assessment in a monocentric cohort of systemic sclerosis patients: is there a role for ultra-high frequency ultrasound? Diagnostics. Published online April 21, 2023. doi.10.3390/diagnostics13081495