The role of local temperature and other clinical characteristics of localized scleroderma as markers of disease activity.

Abstract

Determining the activity of localized scleroderma (LS) remains crucial for decision making, and reliable clinical indicators of activity are lacking. Our objective in this study was to analyze the utility of infrared thermography (IRT) in assessing the activity of LS according to existing clinical scales. A secondary objective was to study whether clinical characteristics of patients and/or IRT have any role in predicting the activity of LS. In this cross-sectional study, the activity of LS was determined using a visual analog scale (VAS), a dyspigmentation-induration-erythema-telangiectasias (DIET) scale, and a localized scleroderma skin severity index (LoSSI). Local temperature was measured by IRT. We studied 56 patients with a median age of 14.2 years. The mean difference in temperature between the affected and unaffected skin was 0.29°C. The comparison of patients with active versus inactive LS (using a 50% composite score cutoff) according to differences in temperature was not significant. An exploratory regression analysis showed an insignificant association of difference in temperature and other clinical characteristics for activity of LS. Our relatively small sample size consisted primarily of patients with low to moderate activity, and the lack of a standard definition of activity of LS was another limitation. There is a possible role for temperature and other clinical characteristics as predictors of activity of LS. More studies and better definitions of activity in LS are needed.