Modified Rodnan skin score (mRSS) calculator

The mRSS quantifies skin thickening in systemic sclerosis by palpation at 17 body sites. Each site is scored from 0 (normal) to 3 (severe); the total ranges from 0 to 51.

⚠︎ Learning tool for medical education – not for use in patients or for treatment decisions.

Calculator

Skin thickness per site (palpation)
Face
Anterior chest
Abdomen
Upper arm right
Upper arm left
Forearm right
Forearm left
Hand right
Hand left
Fingers right
Fingers left
Thigh right
Thigh left
Lower leg right
Lower leg left
Foot right
Foot left
–of 51

🔒 Calculated only in your browser – nothing is stored or transmitted.

Classification (original publication)

ScoreClassification (original publication)
0No palpable skin thickening
1–51Skin thickening present – no validated severity cut-offs – assess course and distribution

Examination technique

At each site, the skin is pinched between thumb and index finger of both hands and its thickness estimated: 0 normal, 1 mild, 2 moderate, 3 so thick that no skin fold can be formed. The standardised procedure by Khanna et al. (2017) reduces inter-observer variability.

Interpretation

There are no validated severity cut-offs for the mRSS. It is mainly used to follow the course of disease. A change of about 3–5 points is considered minimally clinically important. Limited vs. diffuse cutaneous disease is defined by extent proximal to elbows and knees or on the trunk, not by a number. The 2013 ACR/EULAR criteria are classification criteria, not mRSS thresholds.

FAQ

Which mRSS indicates severe scleroderma?▾

There is no validated cut-off. What matters is the distribution, the dynamics (rapid increase in early disease) and organ involvement.

Which change in mRSS is relevant?▾

In trials, a change of about 3–5 points is considered minimally clinically important.

References

  1. Clements P et al. Inter and intraobserver variability of total skin thickness score (modified Rodnan TSS) in systemic sclerosis. J Rheumatol 1995;22:1281–5. · PubMed
  2. Khanna D et al. Standardization of the modified Rodnan skin score for use in clinical trials of systemic sclerosis. J Scleroderma Relat Disord 2017;2:11–8. · PubMed

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Intended purpose: learning tool for medical education only. Not intended for use in patients or for diagnostic or treatment decisions; not a medical device. Calculations follow the cited original publications; no guarantee of completeness or correctness. Last updated: 09/2026 · Dr. Pascal Bafteh