Domsic et al reported the Skin Thickness Progression Rate (STPR) for patients with diffuse scleroderma. The rate of progression correlates with outcome. The authors are from the University of Pittsburgh and National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City.
Patient selection: diffuse scleroderma
Outcomes: renal crisis or death in the 2 years after initial evaluation
Parameters:
(1) modified Rodnan total skin score (mRSS)
(2) time interval between onset of skin thickening and first visit
time interval in years =
= ((date of first evaluation) - (date of skin thickening onset)) / 365
where:
• The date of skin thickening onset was the first time that a patient's fingers became swollen and did not return to normal.
STPR =
= mRSS / (time interval)
STPR
Rate of Progression
< 25
slow
25 to 44
intermediate
> 44
rapid
For a patient with a rapid rate of progression, the odds ratio for renal crisis in the next 2 years was 2.1 and for death was 1.7.
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