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Modified Rodnan Skin Score in Scleroderma Using 5 Sites

Purpose: To evaluate skin involvement in a patient with scleroderma using the 5 site modification of the Rodnan skin score.

Description

Modifications of the original Rodnan score have been devised to overcome practical problems with its use. One of the these modifications involves evaluation of fewer sites (5 rather than 26) and fewer grades (0 to 2 instead of 0 to 4). This score is simple, and it may be applicable to clinical situations where less precision is needed.


 

Sites examined for the 5 site modification:

(1) forearms

(2) lower legs

(3) anterior chest

(4) upper arms

(5) fingers

 

Disease involvement tends to be symmetrical. There are 2 ways to grade:

(1) grade the side more severely involved

(2) take the average of the 2 sides

 

The authors devised 3 different grading schemes with score 0 to 2 (Table 1, page 1278, Silman 1995) based on different mergings of the 0 to 3 point scheme. Method C is:

Description

Skin Score

normal

0

thickened

1

unable to pinch or move

2

 

skin score =

= SUM(points for the 5 sites)

 

Interpretation:

• minimum score: 0

• maximum score: 10

• The higher the score, the more severe and extensive the involvement.

 


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Specialty

Objective

ICD-10