BACKGROUND: Skin ulcers are common vascular complications of systemic sclerosis (SSc). OBJECTIVE: The aim of the study was to identify clinical, biologic, and imaging parameters that constitute risk factors for the occurrence and persistence of skin ulcers. METHODS: One hundred thirty Italian SSc patients were examined at entry and after 20 months of follow-up. RESULTS: The diffuse SSc phenotype with avascular areas on capillaroscopy, thrombophilia, and systemic inflammation as defined by interleukin 6 plasma levels, represented the major risk factors for ulcer development. Infection was associated with a risk of poor or no healing, and cardiopulmonary involvement was a major comorbid factor in patients with ulcers. The presence of infection and avascular areas represented the main determinants for ulcer healing. LIMITATIONS: Our data should be confirmed with a longer follow-up period since skin ulcers represent a frequent vascular complication in scleroderma patients. CONCLUSION: Aggressive therapies aiming at improving angiogenesis and controlling infection and the course of the disease appear to be crucial to obtain ulcer healing.
BACKGROUND:Skin ulcers are common vascular complications of systemic sclerosis (SSc). OBJECTIVE: The aim of the study was to identify clinical, biologic, and imaging parameters that constitute risk factors for the occurrence and persistence of skin ulcers. METHODS: One hundred thirty Italian SSc patients were examined at entry and after 20 months of follow-up. RESULTS: The diffuse SSc phenotype with avascular areas on capillaroscopy, thrombophilia, and systemic inflammation as defined by interleukin 6 plasma levels, represented the major risk factors for ulcer development. Infection was associated with a risk of poor or no healing, and cardiopulmonary involvement was a major comorbid factor in patients with ulcers. The presence of infection and avascular areas represented the main determinants for ulcer healing. LIMITATIONS: Our data should be confirmed with a longer follow-up period since skin ulcers represent a frequent vascular complication in sclerodermapatients. CONCLUSION: Aggressive therapies aiming at improving angiogenesis and controlling infection and the course of the disease appear to be crucial to obtain ulcer healing.
Authors: Falin B Patel; Kara S Couch; Sean McNish; Jonathan D Miller; Robert Siegel; Samantha Easley; Victoria K Shanmugam Journal: Arthritis Care Res (Hoboken) Date: 2017-03 Impact factor: 4.794
Authors: Zhaohong Yin; Laura D Carbone; Mari Gotoh; Arnold Postlethwaite; Alyssa L Bolen; Gabor J Tigyi; Kimiko Murakami-Murofushi; Mitchell A Watsky Journal: Rheumatology (Oxford) Date: 2010-09-07 Impact factor: 7.580