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Measuring Skin-fold Thickness


Skin-fold thickness is used in acromegaly and Cushing's syndrome as an index of skin involvement and therefore disease activity.


  1. The skin is measured using the skin-fold calliper on the dorsum of the hand over the mid point of the third metacarpal bone.
  2. Set the scale on the callipers to zero.
  3. Place the patient's hand flat on the table with the wrist in a neutral or extended position.
  4. A small skin-fold in the long axis of the hand is lifted up and placed between the blades of the calliper so the fold reaches exactly to the top of the jaw-blades.


  • Skin thickness has only a limited role in the diagnosis and the monitoring of acromegaly and Cushing's.
  • Mean skin thickness (see reference) in men is 2.8 mm when 20 yrs old decreasing to 1.75 mm when 70 yrs. Women's skin is approximately 0.2 mm thinner than similarly aged men.
  • 77% of acromegalics have abnormally thick skin (mean + 2 s.d. in 40 year old males >3.4mm).
  • All patients with Cushing's had skin-fold thickness below the mean value but only 42% were abnormally thin (mean - 2 s.d. in 40 year old females <1.5 mm).


A.D. Wright and G.F. Joplin, Acta Endocrinologia 60, 705-711 (1969)