In vivo non-invasive skin imaging of cutaneous involvement in systemic sclerosis

Abstract

Objectives: To evaluate the diagnostic and prognostic value of quantitative biomarkers derived from optical coherence tomography (OCT) measurements for the management of patients with systemic sclerosis (SSc) and to compare their clinical utility with the modified Rodnan skin score (mRSS). Methods: Thirty-seven patients and 38 healthy volunteers were selected. The mRSS was performed in both groups over 17 anatomical sites and OCT images were obtained over 7 of the 17 anatomical sites using 2 commercially available systems. For all sites, both types of images were processed to quantify the optical absorption, area and thickness of the different layers of the skin. Results: For both systems, the 3 most extreme results and usually more affected locations provided statistically relevant data. For one system, the dermal-epidermal junction area, i.e. the integral sum of the optical density, led to significant difference between both groups. For the other system, the junction slope (JS), i.e. the optical density gradient, demonstrated an excellent accuracy in scleroderma diagnosis when mRSS was high in the most relevant lesions, and superior sensitivity and specificity when mRSS was low. Conclusions: This study shows promising results for OCT to provide an objective non-invasive examination tool for early diagnosis of SSc.