title: Correlation between elastosonography and nailfold microvascular alterations in systemic sclerosis patients.
abstract: OBJECTIVE
  Vascular damage and fibrotic process represent the pathophysiological hallmarks of systemic sclerosis (SSc). Peripheral microangiopathy can be early detected by nailfold videocapillaroscopy (NVC), whereas recent studies suggest that ultrasound real time elastosonography (US-RTE) can be a useful tool to evaluate the reduction of skin elasticity. The aim of our study was to investigate possible correlations between NVC microvascular alterations and finger tissue stiffness evaluated with US-RTE in SSc subjects.
  
  
  METHODS
  20 subjects (16 women and 4 men) who met the ACR criteria for SSc were recruited. All subjects underwent complete clinical examination, NVC and US-RTE evaluation. US-RTE was carried out on both the hands, at the level of the palmar surface of the distal phalanx of the fingers.
  
  
  RESULTS
  10 subjects showed limited disease subset (LSS) and 10 showed diffuse disease subset (DSS). Eight patients had 'Early/Active' NVC pattern and 12 had 'Late' NVC pattern. DSS subjects showed highest skin stiffness values when compared to both LSS (p = 0.03) and healthy subjects (p = 0.002). Multiple regression analysis shows an independent association between Late NVC pattern and skin stiffness (R2 = 0.24, p = 0.027).
  
  
  CONCLUSIONS
  This study demonstrates, for the first time, a strong relationship between microvascular alterations and skin stiffness, evaluated with US-RTE, in SSc patients.
authors.affiliation: Rheumatology Research Unit, "Magna Graecia" University of Catanzaro, Italy.
authors.forename: Rosa Daniela
authors.initials: RD
authors.lastname: Grembiale
authors.affiliation: Rheumatology Research Unit, "Magna Graecia" University of Catanzaro, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Bruno
authors.affiliation: Rheumatology Research Unit, "Magna Graecia" University of Catanzaro, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Tripolino
authors.affiliation: Rheumatology Research Unit, "Magna Graecia" University of Catanzaro, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ursini
authors.affiliation: Rheumatology Research Unit, "Magna Graecia" University of Catanzaro, Italy.
authors.forename: Marilena
authors.initials: M
authors.lastname: Calabria
authors.affiliation: Rheumatology Research Unit, "Magna Graecia" University of Catanzaro, Italy.
authors.forename: Saverio
authors.initials: S
authors.lastname: Naty
authors.affiliation: Rheumatology Department, Polytechnic University of the Marche, Jesi, Ancona, Italy.
authors.forename: Marwin
authors.initials: M
authors.lastname: Gutierrez
authors.affiliation: "Pugliese-Ciaccio" Hospital, Catanzaro, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mazzuca
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy / Q000379:methods*; D008875:Middle Aged; D009262:Nails / Q000098:blood supply*; D012595:Scleroderma, Systemic / Q000150:complications* / Q000000981:diagnostic imaging
keywords: Systemic sclerosis; nailfold videocapillaroscopy; ultrasound elastosonography