Use of Cutometer to assess dermal oedema in erysipelas of the lower legs.

Abstract

Inflammatory dermal oedema in erysipelas alters skin mechanics. The aims of this study were to determine the relationship between skin mechanical properties and changes in dermal water content in patients with erysipelas of the lower leg, and to assess the value of measuring skin elasticity in monitoring the effect of therapy. Twenty-five in-patients were studied before treatment and after 10 and 20 days. Visual scoring of oedema, measurements of limb circumference and skin elasticity with a non-invasive suction device (Cutometer) were made on the affected and unaffected lower legs. Indurated skin was characterized by raised delayed distension (Uv ), final distension (Ut ), resilient distension (R), viscoelastic to elastic ratio (Uv /Ue ) and hysteresis (H) and lower immediate distension (Ue ), immediate retraction (Ur ), gross elasticity (Ua /Uf ) and biological elasticity (Ur /Uf ). The visual score of oedema and leg circumference significantly correlated with the increase in Uv Uv /Ue and H and the decrease in Ua /Uf and Ur /Uf . The large 8 mm diameter measuring probe produced more pronounced changes than the small 2 mm probe. As a result of treatment, a significant reduction in viscoelastic parameters (Uv , Uv /Ue , R, H) and an increase in elastic parameters (Ua /Uf , Ur /Ut ) were observed. The non-invasive method applied is suitable for objective assessment of dermal oedema and disease evolution in patients with erysipelas.