A new principle for the diagnosis morphea in the onset of the disease

Abstract

BACKGROUND: Because of the low specificity morphea clinical manifestations in early stages, the differential diagnosis is difficult.

AIMS: The purpose of the research is to propose a new diagnostic method for early stages of localized scleroderma.

MATERIALS AND METHODS: During 2011–2020, 77 patients with clinical manifestations of morphea and 127 controls were examined and included in the study at the LenOblCenter. All participants were conducted a transcutaneous oximetry with the “TCM-400” Radiometer apparatus. The tissue oxygen perfusion (tcpO₂) level from 40 to 50 mm Hg was considered as a reversible decrease, from 30 to 40 mm hg was a borderline decline and the value below 30 mm hg was critical. The following diagnostic skin biopsy was conducted in all 77 patients

RESULTS: Skin biopsy allowed to form 4 research groups: 40 patients with morphea, 12 patients with granuloma annulare, 15 patients with small plaque parapsoriasis and 10 individuals with large plaque parapsoriasis. 7 (17.5%) patients with morphea had normal tcpO₂ values, 9 (22.5%) patients had significant decrease of tcpO₂, 24 patients (60%) showed a reversible decrease of tcpO₂. 3/12 (25%) patients with granuloma annulare and 1 patient (10%) with large plaque parapsoriasis had minor oxygen level decrease. Measurement on the healthy skin showed tcpO₂ decrease in patients with comorbidities ― 3/77 (3.9%) in research group and 28/127 (22%) in controls.

CONCLUSIONS: Transcutaneous oximetry is a new perspective direction in the diagnostic algorithm of the morphea based on the pathogenesis and morphological features of the disease.

Keywords

morphea / clinical dermatology / diagnostics

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