Clinical evaluation of systemic sclerosis: a comprehensive panel of diagnostic tests to assess skin, microvascular and visceral involvement. The Genoese Group for the Study of Systemic Sclerosis.

The work proposes a set of diagnostic tests and relative clinical scores for the staging and follow-up of patients with systemic sclerosis. Thirty-one consecutive patients (30 females, 1 male, age range 17-65 years) affected by systemic sclerosis, according to the American College of Rheumatology criteria for classification of this disease, were enrolled in the study at the time of their first admission to the Department of Internal Medicine in Genoa. The following battery of tests was utilized: nailfold capillary videomicroscopy, esophageal manometry and pH-metry, lung vital capacity and diffusing capacity for carbon monoxide, intrarenal duplex Doppler sonography, echocardiography and skin plicometry. Good compliance by the patients was obtained for the tests we used. We found that nailfold capillary videomicroscopy and plicometry scores were statistically associated each other as well as with the scores measuring esophagus and/or lung function. The use of wide range of diagnostic procedures, such as those proposed in this paper, allows appropriate definition of the stage of patients with systemic sclerosis. The use of nailfold capillaroscopy and skin plicometry as the simplest tests for monitoring patients is suggested: the scores derived from these procedures are statistically associated with some internal organ status and could be useful in the evaluation of therapeutical results.