Skin ulcers in systemic sclerosis: determinants of presence and predictive factors of healing.

Abstract:

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.

journal_name

J Am Acad Dermatol

authors

Alivernini S,De Santis M,Tolusso B,Mannocci A,Bosello SL,Peluso G,Pinnelli M,D'Antona G,La Torre G,Ferraccioli G

doi

10.1016/j.jaad.2008.11.025

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

426-35

issue

3

eissn

0190-9622

issn

1097-6787

pii

S0190-9622(08)01458-8

journal_volume

60

pub_type

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