DUROMETER MEASUREMENTS OF SKIN INDURATION IN VENOUS DISEASE

BACKGROUND. The degree of skin induration (lipodermatosclerosis) aroun d venous ulcers has prognostic significance; however, objective measur ements are needed to assess the induration. The durometer, an engineer ing instrument used to measure the hardness of metals and plastic, has recently been adapted to assess skin induration. OBJECTIVE. The purpo se of this study was to measure skin induration and its relationship t o skin ulceration by the use of a durometer, and to determine the infl uence of edema, if any, on durometer measurements. METHODS. The degree of skin induration on the medial leg was determined in sh sequential, nonselected patients with lipodermatosclerosis and leg ulcers, and in five normal volunteers by using a blinded observer's clinical score ( 0 = normal to 3 maximal induration) and a hand-held Type 0 durometer. In addition, durometer readings in 14 patients with edema and eight co ntrol subjects were taken on the tibia, the dorsum of the foot, and be hind the ankle. RESULTS. Durometer readings in patients with leg ulcer s and lipodermatosclerosis diminished as one measured from the superio r edge of the ulcer to the knee (r = 0.925). The higher the clinical s kirt score the higher were the durometer readings (P = 0.0062). The pr esence of enema did not influence durometer measurements. CONCLUSION. The durometer is an effective and reliable instrument for measuring th e degree of skin induration in venous ulceration and its readings are not affected by edema. Ulcers occur in skin most affected fry lipoderm atosclerosis. (C) 1997 by the American Society for Dermatologic Surger y, Inc.