Use of a durometer to measure the degree of skin induration in lipodermatosclerosis.
BACKGROUND
Chronic lipodermatosclerosis is characterized by indurated skin on the medial aspect of the leg and is common around venous ulcers. The severity of induration of lipodermatosclerosis has been associated with poor ulcer healing. Clinical assessment of lipodermatosclerosis presently relies on a clinical skin severity score adapted from studies of patients with systemic sclerosis.


OBJECTIVE
It would be desirable for prognostic reasons to develop an objective method for measuring skin hardness in lipodermatosclerosis.


METHODS
The degree of skin induration at the midpoint between the upper and lower margin of lipodermatosclerosis in 30 sequential nonselected patients with lipodermatosclerosis was assessed by a blinded observer's clinical score and by quadruplicate determinations with a hand-held type O durometer. Skin induration on the medial aspect of the leg was similarly measured in five normal volunteers. Transcutaneous oxygen pressure was measured at the same sites.


RESULTS
A direct linear relation (r = 0.962) was found between skin severity scores and durometer readings (p < 0.01). A clinical skin score of 2 reflected a higher durometer reading compared with a skin score of 1 (p = 0.0016) and, similarly, higher durometer readings were found in skin score of 3 compared with score 2 skin (p = 0.0093). Transcutaneous oxygen pressure was uniformly reduced in lipodermatosclerosis (p < 0.02).


CONCLUSIONS
The durometer is a reliable instrument for measuring skin hardness in patients with lipodermatosclerosis. It may be used to test the prognostic value of lipodermatosclerosis on ulcer healing.
Romanelli
M
M
Department of Dermatology, University of Pisa School of Medicine, Italy.
Falanga
V
V
D001785:Blood Gas Monitoring, Transcutaneous; D002908:Chronic Disease; D003880:Dermatology / Q000295:instrumentation*; D005260:Female; D006244:Hardness; D006801:Humans; D007868:Leg Dermatoses / Q000097:blood / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012594:Scleroderma, Localized / Q000097:blood / Q000473:pathology*; D012595:Scleroderma, Systemic / Q000473:pathology; D012720:Severity of Illness Index; D016037:Single-Blind Method; D012867:Skin / Q000473:pathology*; D014647:Varicose Ulcer / Q000473:pathology