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

D V Zaslavsky,A. A. Sidikov, L. V. Garyutkina, Grigoriy B. Pyagai, Muyassar D. Alaeva,Nargiza Ibragimova,Nilufar N. Malikova,Darya Kozlova

Rossiiskii Zhurnal Kozhnykh i Venericheskikh Boleznei(2021)

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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 20112020, 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.
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Key words
diagnosis morphea,disease,onset
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