Assessment of modified Rodnan skin score and esophageal manometry in systemic sclerosis: a study correlating severity of skin and esophageal involvement by objective measures.

INTRODUCTION: Systemic sclerosis (SSc) is a multisystem connective tissue disease characterized by immune-mediated activation of tissue fibroblasts and consequent fibrosis, vascular abnormalities, and inflammation. The skin and esophagus are the two most frequently involved organs in this disease. Data regarding the correlation between the severity of skin and esophageal involvement in SSc by objective measures are negligible so far.

METHODS: Thirty-one patients with SSc were subjected to esophageal manometry. A correlation between modified Rodnan skin score (MRSS) and esophageal manometric parameters of lower esophageal sphincter pressure (LESP), percentage relaxation of the lower sphincter, amplitude, and duration of the peristaltic waves was established.

RESULTS: The mean MRSS was found to be 16.9 ± 8.7. There was no statistical correlation between MRSS and LESP (p = 0.496), percentage relaxation (p = 0.070), amplitude (p = 0.531), and duration (p = 0.459) of the contractions. No difference between these manometric parameters was found if the patients were divided into limited and diffuse subsets.

CONCLUSION: There exists no correlation between the severity of skin involvement measured by MRSS and manometric abnormalities in SSc. All patients with SSc should undergo esophageal manometry irrespective of the extent of skin involvement.