Rodnan Skin Score Training

The modified Rodnan skin score (MRSS), a measure of skin thickness, has been used as the primary outcome measure in clinical trials of diffuse cutaneous SSc (dcSSc). Measurement of skin thickness is used as surrogate measure of disease severity and mortality in patients with dcSSc— an increase in skin thickening is associated with involvement of internal organs and increased mortality. The MRSS is feasible, reliable, valid, and sensitive to change in multicenter clinical trials. Dr. Gerald Rodnan at the University of Pittsburgh  studied the trajectory of skin thickening in the course of SSc. He noted that the skin, particularly the dermis, thickened initially and after some years usually thinned. He became convinced that an observer could, with practice, accurately estimate how thick skin is by palpating it. To substantiate his point, he developed a method for estimating thickness by clinical palpation using a 0-4 scale and showed that the correlation between his clinical estimate of thickness and the weight of a 7-mm punch biopsy plug was 0.81. Some years later, Dr. Rodnan’s colleagues modified his method by estimating skin thickness using a 0-3 scale in 17 body areas. 

The SCTC offers formal training in MRSS that leads to a certificate and can be applied to the ongoing clinical trials. The training is conducted over half-a- day and includes:

  1. Teaching phase:  Video demonstration (by Dr Furst examining a patient with SSc demonstrating different aspects of skin scoring) followed by a live demonstration by an expert on 2 or more patients with SSc.

Review the JSRD article. Standardization of the modified Rodnan skin score for use in clinical trials of systemic sclerosis. Khanna D, Furst DE, Clements PJ, Allanore Y, Baron M, Czirjak L, Distler O, Foeldvari I, Kuwana M, Matucci-Cerinic M, Mayes M, Medsger T Jr, Merkel PA, Pope JE, Seibold JR, Steen V, Stevens W, Denton CP. J Scleroderma Relat Disord. 2017 Jan-Apr;2(1):11-18. Download PDF file: JSRD-D-16-00071.

  1. Evaluation Phase: Each trainee examines at least 3 patients with SSc , score each patient, and assess their scores versus consensus score of the teachers.

Or you can see the video here:

(You may be able to get a higher resolution video on Youtube.)