Modified Rodnan Skin Score and its Association with Extent of Lung Damage in Systemic Sclerosis Patients

Abstract

Back Ground: Systemic sclerosis is a progressive, multi-organ autoimmune connective tissue disorder associated with widespread skin and internal organ fibrosis. Skin thickness correlates with organ invol-vement. Modified Rodnan skin score (MRSS) is a reliable way to measure skin thickness for assessing severity and outcome of the disease. Objective: To evaluate association of MRSS with severity of lung disease in systemic sclerosis. Methods: A cross-sectional study was conducted at Department of Rheumatology and Immunology Shaikh Zayed Hospital, Lahore from January 2020 - June 2020. After approval from Institutional Review Board 35 patients fulfilling the inclusion criteria were included through non-probability/convenience sampling. After a detailed history MRSS was measured using standard method. Pulmonary manifestations and internal organ assessment were done performing Force Vital Capacity (FVC), X-ray chest, echocardiography and High-Resolution CT scan chest (HRCT). Data was analyzed in SPSS ver: 25.0. Pearson correlation was calculated for MRSS and FVC. MRSS was cross tabulated with interstitial lung disease (ILD) and pulmonary hypertension. Chi-square test was used for statistical significance at p < 0.05. Results: The mean age was 43.17 years + 11.67. 85.7% were females. 88.6% were married, with no family history of disease and smoking. Mean FVC was 67.428 + 16.077. MRSS range was 4-45 with a mean MRSS score of 17.800 + 11.208. Pearson product moment correlation revealed negative correlation of MRSS with FVC, r = -0.428 P = 0.010. MRSS was cross tabulated with ILD and showed statistically significant result with P = 0.006. Pulmonary hypertension was present in 42.9% of patients. Of these 53.3% had mild, 33.3% and 13.3% had moderate and severe thickening on MRSS respectively. (p = 0.590). Conclusion: MRSS is a reliable tool for assessing and evaluating severity of lung disease in systemic sclerosis.