Longitudinal Spatial Frequency Domain Imaging Study
- Conditions
- Systemic Scleroderma
- Interventions
- Other: Spatial-frequency domain imaging (SFDI)
- Registration Number
- NCT05672992
- Lead Sponsor
- Boston University
- Brief Summary
Scleroderma (SSc) is an autoimmune disease characterized by fibrosis (or collagen deposition) of the skin and internal organs. The extent of skin fibrosis is an important predictor of internal organ complications and increased mortality. Currently imprecise and subjective methods that varies amongst different doctors for the same patient are available to quantify skin fibrosis in patients, by "pinching" their skin and assessing how thick it is; this is the method used to determine the modified Rodnan skin score (mRSS).
Skin thickness and the amount of fibrosis can change over time due to disease progression or in response to therapy. In this research, longitudinal measurements will be taken to determine if spatial frequency domain imaging (SFDI) can detect changes in skin thickness that occur over time in response to therapy or from disease progression in scleroderma patients.
This study will compare SFDI with other clinical outcome assessments of skin thickness and fibrosis in scleroderma patients including mRSS, skin biopsy histology, scleroderma skin patient reported outcome (SSPRO), ultrasound, and durometry (durometer measures skin hardness). SFDI information will also be compared with capillaroscopy (allows for non-invasive imaging of the nailfold capillaries) if available from the electronic medical record. If SFDI correlates well with other clinical outcome assessments, it may be used in the future as a rapid, non-invasive tool for monitoring disease activity in scleroderma patients.
- Detailed Description
The overall objective of this study is to determine if a light emitting diode (LED) -based SFDI instrument can be used to detect changes in skin thickness over time in SSc patients.
Number of subjects:
60 patients with scleroderma and 32 control subjects without scleroderma
Study procedures:
All subjects will have 6 areas of the body, right and left fingers, hands, and forearms, measured with an LED-based SFDI instrument every 3 months for the first 12 months and then every 6 months through 36 months. The right and left upper arms of subjects may be measured with the SFDI instrument if subjects are able to comfortably extend their arms.
All subjects will have the option to have blood collected for serum at baseline, 12 months, 24 months, and 36 months to investigate serum biomarkers of fibrosis.
An optional skin biopsy will be collected from all subjects at baseline, 12 months, 24 months, and 36 months to evaluate histopathological skin changes. Skin biopsies will not be collected from pregnant or lactating subjects, from subjects with a history of an allergic reaction to a local anesthetic, or from subjects who are deemed by the study doctor to be at high risk of small tissue calcification.
Scleroderma subjects will be asked to complete the SSPRO questionnaire at baseline and every 3 months for the first 12 months and then every 6 months through 36 months.
Scleroderma subjects will have a mRSS performed at baseline and every 3 months for the first 12 months and then every 6 months through 36 months.
All subjects will have durometry and ultrasound performed on the right and left forearms at baseline and every 3 months for the first 12 months and then every 6 months through 36 months.
Secondary Objectives:
* Assess how SFDI measurements correlate with other clinical measurements of skin thickness such as durometry, ultrasound, and mRSS
* Assess how SFDI measurements correlate with clinical biochemical and histopathological assessments of skin changes in SSc.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 92
Participants must meet at least one of the following:
- Have SSc as defined by the American College of Rheumatology (SSc subjects only)
- Suspected of having SSc based on clinical symptoms as determined by their physician (SSc subjects only)
- Defined as a healthy control (does not have SSc or another known disease that in the opinion of the investigator could confound the results)
- Diagnosis of skin malignancy within the previous 2 years, excluding adequately treated squamous cell skin cancer, basal cell carcinoma, and carcinoma in situ.
- Presence of wounds or skin rashes at the site of Spatial frequency domain imaging (SFDI) measurement or skin biopsy
- Presence of other co-morbid illnesses with an estimated median life expectancy < 5 years.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Scleroderma Participants Spatial-frequency domain imaging (SFDI) Participants in this arm will be asked to complete the Fitzpatrick skin type questionnaire to quantify skin tone and will have measurements taken with a colorimeter on the right and left forearms, hands, and fingers to quantify skin tone at the first study visit. Participants will be asked to complete the SSPRO questionnaire at the time of enrollment and every three months for the first 12 months and then every six months until the end of the study. At each study visit, a physician will measure the mRSS, which is a method of quantifying skin fibrosis; SFDI measurements, ultrasound, and durometry will then be done. Skin biopsies will be collected from the forearm of each subject annually. A small amount of blood will also be collected from subjects once per year to explore serum biomarkers of fibrosis. Healthy controls Spatial-frequency domain imaging (SFDI) Participants in this arm will be asked to complete the Fitzpatrick skin type questionnaire to quantify skin tone and will have measurements taken with a colorimeter on the right and left forearms, hands, and fingers to quantify skin tone at the first study visit. At each study visit, SFDI measurements, ultrasound, and durometry will be done. Skin biopsies will be collected from the forearm of each subject annually. A small amount of blood will also be collected from subjects once per year to explore serum biomarkers of fibrosis.
- Primary Outcome Measures
Name Time Method Baseline SFDI measurements of skin thickness baseline SFDI measurements will be obtained on the right and left fingers, hands, and upper arms and forearms
6 months SFDI measurements of skin thickness 6 months SFDI measurements will be obtained on the right and left fingers, hands, and upper arms and forearms
12 months SFDI measurements of skin thickness 12 months SFDI measurements will be obtained on the right and left fingers, hands, and upper arms and forearms
18 months SFDI measurements of skin thickness 18 months SFDI measurements will be obtained on the right and left fingers, hands, and upper arms and forearms
24 months SFDI measurements of skin thickness 24 months SFDI measurements will be obtained on the right and left fingers, hands, and upper arms and forearms
30 months SFDI measurements of skin thickness 30 months SFDI measurements will be obtained on the right and left fingers, hands, and upper arms and forearms
36 months SFDI measurements of skin thickness 36 months SFDI measurements will be obtained on the right and left fingers, hands, and upper arms and forearms
- Secondary Outcome Measures
Name Time Method Serum fibrosis biomarkers, Pro-inflammatory cytokines involved in immune cell migration baseline and every 12 months up to 36 months Assessed from serum
Serum fibrosis biomarkers, Matricellular proteins baseline and every 12 months up to 36 months Assessed from serum
histopathological assessments of skin collagen content baseline and every 12 months up to 36 months Assessed from skin biopsy samples
Serum fibrosis biomarkers, Chemokines that promote fibrosis baseline and every 12 months up to 36 months Assessed from serum
Trial Locations
- Locations (1)
Shapiro Outpatient Rheumatology Clinic at Boston Medical Center
🇺🇸Boston, Massachusetts, United States