Description

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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