Systemic sclerosis (SSc) or scleroderma is a progressive autoimmune disorder characterized by changes in the texture and appearance of the skin caused by increased connective tissues buildup. The disease can affect many other parts of the body, but often only affects the skin in the early stages or limited forms of the disease. In 2013, the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) published and enhanced the classification guidelines1 for SSc, which give more sensitivity to the early and limited cutaneous forms of the disease. Besides thickening of skin on the fingers, there are several factors linked to the (micro-) circulation that are involved in the new classification. One is the damage of the capillaries, that can be detected by nailfold video-capillaroscopy (NVC) and that improved the specificity and sensitivity of the 2013 EULAR/ACR SSc classification criteria.
In recent years, there have been several studies indicating that laser speckle contrast analysis (LASCA) can be a valuable technique for further SSc research and as a diagnostic tool in the classification of the disorder.2,7
Several studies also show the technique to be useful for assessing and monitoring the effect of treatment.10,12 One way to study the effect of locally administered drugs is by using iontophoresis in combination with LASCA.11
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Iontophoresis is a technique to transport charged molecules or drugs across a tissue barrier. Combined with LASCA, iontophoresis is a valuable tool for studying the effect of locally administered drugs on systemic sclerosis patients.