Pattern of skin thickness progression and clinical correlation in Thai scleroderma patients
Skin thickness progression in scleroderma (SSc) varies in daily clinical practice observation.To define the pattern of skin thickness among Thai sufferers of SSc and to ascertain the clinical correlation with each skin pattern.A 3-year follow-up cohort was performed on patients over 15 years of age in Khon Kaen, Thailand, between January 1, 2005 and December 31, 2006. The progression of skin thickness equals the modified Rodnan skin score at the end minus the score at onset divided by the duration of the disease.SSc cases (117) were included and the female-to-male ratio was 70:47. The mean age at onset was 49.8 years (range 24.4-75.5). The most common skin patterns were: (i) 'slow progression to peak then slow regression' (77 cases; 65.8%); followed by (ii) 'continuous slow progression' (37; 31.6%); (iii) 'continuous intermediate progression' (2; 1.7%); and (iv) 'slow progression to peak then intermediate regression' (1; 0.9%). The respective mean peak skin score and duration of disease at peak skin score was 19.8 points (range 4-45) and 20.3 months (range 1.0-42.2). Only telangiectasia at onset and contracture of joint(s) were related to 'continuous slow progression' of skin thickness with P=0.001 and P=0.042, respectively. Neither SSc subsets nor internal organ involvement were correlated with skin thickness pattern.The most common skin pattern in Thai SSc was 'slow progression to peak then slow regression'. Telangiectasia at onset and contracture of joint(s) were predictive of continuous progressive skin thickness in the first 3 years.