Skin involvement is measurable in Dupuytrens’ disease: Reliability of standardized skin elasticity measurements with Cutometer® MPA 580

Abstract

Introduction

Skin involvement is a clinically relevant but insufficiently quantified feature of Dupuytren’s disease (DD). The Cutometer® MPA 580 offers an objective method to assess skin biomechanics, yet its reliability on healthy and DD-affected hands has not been examined using a hand-specific protocol.

Methods

In this cross-sectional study, two observers performed Cutometer® measurements on 31 DD-affected and 30 healthy hands using a standardized hand protocol. In DD patients, measurement sites were classified on skin involvement (fused vs non-fused). Reliability was assessed using ICC (2, 1), SEM, reproducibility coefficient (RC), and within-subject coefficient of variation (WSCV). Agreement was evaluated with Bland–Altman analysis. Differences between fused and non-fused sites were analysed for Uf (R0) and Ua/Uf (R2).

Results

Uf (R0) showed good intra-observer reliability on palmar regions in both healthy and DD hands. Reliability decreased on anatomically restricted areas, particularly along the ulnar side of the fourth digit, and inter-observer reliability was consistently lower. Ua/Uf (R2) showed acceptable intra-observer reliability for one observer, while inter-observer agreement remained poor. Absolute errors were smallest on the palm and highest in stiff or curved regions. Fused sites demonstrated lower maximal deformation (Uf) than non-fused skin, although interpretation is limited by the absence of precise anatomical site recording.

Conclusion

Using a hand-specific protocol, the Cutometer® provides reliable within-observer measurements on palmar skin, while digit measurements are less consistent. Differences between fused and non-fused skin support construct validity. Further standardization is recommended to support clinical and longitudinal use in hand evaluation.