Abstract
Background/objectiveDigital ulcers (DUs) represent a frequent complication of systemic sclerosis (SSc). The aim of this study was to evaluate clinical, serological and capillaroscopy features that are associated with DUs in patients with SSc.MethodsIn this bicentric cross-sectional study, 70 patients with SSc were consecutively selected from March 2016 to April 2017. Demographic and clinical features, including the presence of active DUs, were collected. Videocapillaroscopy was performed in all patients.ResultsAmong the 70 patients included (mean age of 46.8 years, mean disease duration of 9.41 years), 14 (20%) had active DUs. Based on multivariate analysis, the presence of anti-Scl-70 antibodies, the HAQ-DI score, and the capillary loss score were independently associated with DUs with odds ratios of 7.96 (95% CI 1.32–47.99), 55.77 (95% CI 1.76–1764.28), and 16.66 (95% CI 2.07–133.81), respectively.ConclusionsThe presence of avascular areas in capillaroscopy, elevation of HAQ-DI score and anti-Scl-70 antibodies were independent factors associated with DUs in patients with SSc.
Highlights
Systemic sclerosis (SSc) is an autoimmune connective tissue disease with heterogeneous clinical presentation and a variable and unpredictable course [1, 2]
Multivariate analyses were performed, and odds ratio (OR) and the corresponding 95% confidence intervals (CI) were calculated to determine independent risk factors associated with Digital ulcers (DUs)
Multivariate analysis revealed that the presence of anti-Scl-70 antibodies and elevated Health Assessment Questionnaire Disability Index (HAQ-DI) score were independent factors associated with DUs in patients with SSc with an OR of 7.96 and 55.77, respectively
Summary
Systemic sclerosis (SSc) is an autoimmune connective tissue disease with heterogeneous clinical presentation and a variable and unpredictable course [1, 2]. The pathogenesis of SSc is characterized by a triad of distinct abnormalities: vascular injury, autoimmunity, and skin thickening and tissue fibrosis of internal organs, including the lungs, heart, and gastrointestinal tract [3, 4]. Raynaud’s phenomenon (RP) is almost universal and frequently the first symptom of SSc [8]. Fibrosis of the media and adventitia layers as well as obliteration of the small arteries and microvessels may lead to digital ulcerations [6]. Digital ulcers (DUs) are a frequent clinical complication in these patients and may occur in greater than half of patients at some point in the evolution of SSc. These
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