Scleroderma: skin stiffness assessment using the stress-strain relationship under progressive suction.

Introduction: A few non-invasive biometrological methods are available for monitoring skin stiffening in systemic scleroderma. Among them, the Cutometer® is used for years by several clinical teams.

Objectives: To revisit the microscopic structure of the dermal fibrous networks in scleroderma and the relationship with changes in viscoelasticity.

Methods: The suction method delivered by the Cutometer® was applied following the progressive stress-vs-strain modality.

Results: The test procedure was sensitive enough to document the initial progression steps of acroscleroderma. Four stages were thus identified including i) the incipient, ii) the progressive, iii) the overt, and iv) the regressive acroscleroderma.

Conclusion: The non-invasive determination of skin biomechanical functions is relevant both in routine clinical practice and in antisclerotic drug development. It is complementary although not a substitute for the determination of selected serum biomarkers.