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Aim: To analyze the exercise tolerance and thoracic mobility of patients with systemic scleroderma treated at the Department of Dermatology of the PIM of the Ministry of Internal Medicine after 2 years of individually tailored rehabilitation. Materials and Methods: The study group consisted of 55 patients aged 27 years to 80 (mean 56.4) with systemic scleroderma, who receive rheological treatment in the Department of Dermatology on a cyclical basis. In addition, the therapy was supported by individually tailored rehabilitation for 2 years. Before and after the therapy was completed, the results of the study were analyzed. Forty-two patients completed the project. Results: The results of the 6-minute walk test improved over the course of the project. More than half of the patients obtained results within the normal range 57.1% of the patients improved their results by completing the test compared to the beginning of the study. On the other hand, the chest circumference values obtained allow us to conclude that its momentum decreased after 2 years of rehabilitation. Conclusions: When interpreting the result of the 6-minute test measurements, it is also necessary to take into account gait altered by changes in the skin of the feet and limitations due to muscle function. The study also shows a significant reduction in joint mobility under the influence of the lesioned skin and subcutaneous tissue. [ABSTRACT FROM AUTHOR]

Aim: To analyze the functional performance of patients with generalized scleroderma treated at the Department of Dermatology of the PIM of the Ministry of Internal Affairs and to develop recommendations for physiotherapists. Systemic sclerosis (SSc) is a chronic connective tissue disease characterized by progressive fibrosis of the skin and internal organs, the presence of microcirculatory disorders and the presence of autoantibodies. Materials and Methods: The study group consisted of 55 patients aged 27 years to 80 (mean 56.4) with systemic scleroderma, who receive rheological treatment in the Department of Dermatology on a cyclical basis. In addition, pharmacotherapy was supported by individually tailored rehabilitation for 2 years. Before and after the completed therapy, the results of the study were analyzed and recommendations were created for physiotherapists. Forty-two participated in the study. Results: All patients had mobility restrictions in the proximal and distal interphalangeal joints of both hands and in both temporomandibular joints. Conclusions: The study confirmed the need for guidelines for physiotherapists. [ABSTRACT FROM AUTHOR]

Systemic sclerosis is a chronic disease involving the connective tissue of the skin and internal organs. It is characterised by disorders of peripheral microcirculation, immune dysregulation, and deposition of collagen fibres and other substances in connective tissue. The most common organ complications in systemic sclerosis include interstitial lung disease, pulmonary arterial hypertension, renal tubular hypertrophy, and arthritis. Imaging findings often precede clinical symptoms, so all patients should be screened as soon as possible, preferably in the asymptomatic phase of the disease. Treatment options for systemic sclerosis include immunomodulatory therapies as well as therapeutic modalities targeting vascular mechanics and connective tissue fibrosis. Efforts are underway to discover new, more sensitive and specific prognostic factors that would help to personalize therapies and thus improve the final treatment outcomes. Identified biomarkers would accelerate the implementation of appropriate treatments, delaying the progression of irreversible complications and decreasing mortality rates in patients. [ABSTRACT FROM AUTHOR]

Introduction: Scleroderma (Sc) is a connective tissue disorder associated with internal organ involvement, increased mortality, and unknown pathogenesis. It has been found that the more extensive the skin involvement the more severe internal organ manifestations and increased disability. The Rodnan skin score (RSS) is one of the established methods to examine skin thickness among patients with Sc. Due to RSS limitations, for instance, lack of detection of subclinical changes, a new tool is needed for the evaluation of Sc. In recent studies, shear wave elastography (SWE) has been examined as a potential tool to assess skin involvement through the evaluation of skin strain. Aim: To verify whether elastography is a reliable method to examine Sc progression and possibly provide one useful site to perform the examination - as an easy, cheap, and reliable examination tool. Material and methods: Forty Sc patients were examined, and 28 healthy individuals were recruited for the control group. Among the patients and control group, skin thickness was assessed using the RSS and skin strain measurements using elastography in 20 body locations. Results: SWE in the right-hand finger can be treated as an important diagnostic indicator of the severity of Sc. Conclusions: SWE is a reliable method for evaluating skin involvement among patients with systemic sclerosis (SSc). Right finger measurements correlate positively with Rodnan's results and can be a predictor of the severity of SSc. This study found SWE to be a reliable method for examining SSc progression and possibly one useful site for the examination. [ABSTRACT FROM AUTHOR]

To collect evidence on the application of ultrasound in skin assessment in patients with systemic sclerosis (SSc). The authors carried out a review of the literature via Pubmed MEDLINE database. The search terms were: skin imaging in systemic sclerosis, ultrasound skin imaging in patients with systemic sclerosis. The selection and analysis of articles were performed by two independent evaluators. The authors analyzed 10 studies characterizing 470 patients with systemic sclerosis. The patients were young adults, mainly women. The described methods of ultrasound were: ultrasound elastography (7.14%), ultra-high-frequency (7.14%) and B-mode ultrasonographic imaging (21.43%), high-frequency ultrasonography (21.43%), shear-wave elastography (21.43%) and others (21.43%). Skin measurements reported in the analyzed studies were: skin ultrasound in all studies, skin thickness (8 studies), skin elasticity (5 studies), skin stiffness (2 studies), subcutaneous tissue thickness (1 study). Ultrasound measurements were compared to different types of scales and measurements used in the description of disease progression. Ultrasound may be used in the clinical assessment of skin involvement in SSc. To the best of our knowledge, articles currently reporting the use of ultrasound in skin imaging show interesting ideas and provide basis for further research. Skin involvement in SSc assessed with ultrasound should be compared to skin biopsy. It is necessary to develop guidance for conducting skin measurements using ultrasound in patients with scleroderma. Currently, skin imaging in SSc is of limited clinical use due to a variety of methods and the lack of a standard operating procedure. The authors of analyzed studies suggested that high-frequency ultrasound provided a quantitative and reliable evaluation of dermal thickness in patients with SSc. [ABSTRACT FROM AUTHOR]

The assessment of skin fibrosis is vital for the diagnosis and monitoring of treatment in the systemic sclerosis (SSc)—a severe autoimmune disease. The elastography is a technique of skin fibrosis assessment through the evaluation of skin strain. We compared the efficacy of the shear wave elastography (SWE) and commonly used modified Rodnan skin score (RSS) in skin fibrosis assessment in SSc. The study included 40 SSc patients and 28 healthy individuals, with the exclusion of individuals with other skin/autoimmune diseases. Skin thickness using RSS and skin strain using SWE were assessed in the same 20 body localizations. Subjects' informed consent and the bioethics committee approval were obtained. Elastographic skin strain correlated positively with both partial and overall RSS values, with strong positive correlation (r ≥ 0.75) for hands and fingers localizations in particular. In SSc patients with normal RSS values, the elastographic strain was significantly higher than in healthy controls. Elastographic strain of fingers' skin evaluated in SWE is highly accurate for distinguishing SSc patients (sensitivity 0.897–0.923, specificity 0.929–0.964, positive predictive value 0.946–0.973, negative predictive value 0.867–0.900). ESW results are substantially more reproducible than those of RSS examination (intraclass correlation coefficients: 0.987 vs. 0.941). The shear wave elastography is more reproducible and has higher sensitivity than RSS in the evaluation of skin condition in SSc, especially in case of changes non-detectable on physical evaluation, indicating it might become a useful tool in SSc diagnosis. [ABSTRACT FROM AUTHOR]

Systemic sclerosis is a chronic autoimmune disease of still not fully understood pathogenesis. Fibrosis, vascular wall damage, and disturbances of innate and acquired immune responses with autoantibody production are prominent features. Systemic sclerosis has specific subsets with different autoantibodies, and differences in the affected skin areas. The suspicion of systemic sclerosis and establishing the diagnosis will be facilitated by the criteria created by EULAR/ACR experts. The treatment of this autoimmune disease remains a challenge for clinicians and new therapeutic options are constantly sought. The occurrence of various symptoms and the involvement of many organs and systems make systemic sclerosis a multidisciplinary disease and require a holistic approach. The present article summarizes different clinical features of systemic sclerosis and the profile of autoantibodies and discusses recent rules and future perspectives in disease management. [ABSTRACT FROM AUTHOR]

Introduction: A fast and cheap method of skin assessment in systemic sclerosis (SSc) is an area of extensive research. Established in 1979, the Rodnan skin score is a palpation-based method used among clinicians. This method has some limitations, such as: examiner's skills, subjective results, and no standardization. In the last few years researchers have been exploring ultrasound-based techniques as a possible tool for skin assessment among patients with SSc. The aim of the study is to develop a protocol of elastography-based skin imaging evaluation among patients with SSc. Material and methods: Review of the literature and own experience. Results: Proposition of elastography-based skin imaging protocol among patients with SSc. Conclusions: The authors present a potential protocol of ultrasound-based examination of skin involvement among patients with SSc. [ABSTRACT FROM AUTHOR]