Comparison of modified rodnan skin score and capillaroscopic findings in patients with systemic sclerosis

Purpose: Modified Rodnan Skin Score is used to evaluate skin thickness in patients diagnosed with systemic sclerosis. Capillaroscopy is a non-invasive examination performed by examining the microvascular structures in the nail bed and is used in treatment and follow-up. The purpose of this study will be to compare the Modified Rodnan Skin Score and capillaroscopic findings. Materials and Methods: The study was conducted with 107 (98 women) patients diagnosed with systemic sclerosis. Patient information and values were evaluated retrospectively from the hospital system. Modified Rodnan Skin Scores, capillaroscopic findings, demographic characteristics, clinical manifestations, treatments received and laboratory parameters of all patients were evaluated. Capillaroscopic findings were classified as non-specific, normal, active period, early period and late period. Results: 107 patients participating in the study were divided into 4 main groups according to their capillaroscopic patterns: normal/non-specific, active period, early period and late period. When the groups are compared, gender, smoking, alcohol use, follow-up period, presence of type 2 diabetes mellitus, presence of hypertension, presence of COPD, presence of asthma, presence of arrhythmia, presence of hypothyroidism, presence of arthritis and arthralgia, GIS involvement, Thorax CT involvement pattern, presence of calcification, the presence of telangiectasis, ECO parameters, FEV1/FVC ratio, and laboratory parameters except 3 parameters there were no significant difference. (p>0.05). Raynaud's phenomenon was seen significantly less in the patient group with normal/non-specific capillaroscopic findings (p=0.009). The presence of digital ulcers was significantly higher in the patient group with late capillaroscopy findings. (p=0.008) Lung involvement was significantly higher in the patient group with late capillaroscopy findings. (p=0.045) The use of MMF treatment and iloprost treatments was significantly higher in the late period. It was found to be significantly higher in the patient group with capillaroscopic findings. (P value 0.008 and <0.001, respectively) FEV1 and FVC values showed a significant difference when these two groups showing early and late capillaroscopic findings were compared with each other. (P = 0.012). BNP median value showed a significant difference in the patient group with late capillaroscopic findings (P=0.036). The presence of anti-centromere antibodies was found to be significantly lower in the group with late capillaroscopic findings (P=0.013). Serum C4 value was found to be significantly lower in the group with late capillaroscopic findings. (p=0.032). Modified Rodnan Skin Score was found to be significantly higher in the patient group with late capillaroscopic findings. (P<0.001) When looking at the relationship between MRSS and organ involvement, MRSS was found to be significantly higher in patients with GIS involvement (p <0.001), Lung involvement (<0.001), presence of telangiectasia (p = 0.005) and Raynaud's Phenomenon (p = 0.001). These findings correlate with studies in the literature. Conclusion: In this study, statistically significant differences were found between the Modified Rodnan Skin Score and capillaroscopic findings in the presence of digital ulcer, Raynaud's Phenomenon, lung involvement, MMF and iloprost treatments, FVC value, BNP value, presence of anti-centromere antibody and serum C4 levels. Additionally, MRSS was found to be significantly higher in patients with lung involvement, GI involvement, Raynaud's Phenomenon and Telangiectasia. Key Words: Modified Rodnan Skin Score, capillaroscopy, interstitial lung disease, systemic sclerosis