Sparing effect of hemiplegia on skin fibrosis and microvascular involvement: reports of two cases of systemic sclerosis and review of the literature.

Abstract:

OBJECTIVES:The sparing effect of hemiplegia in rheumatic diseases has been described, but reports on systemic sclerosis (SSc)-spectrum disorders are unusual. SSc-spectrum disorders are complex diseases of unknown origin characterized by multisystem involvement, skin and organ fibrosis, microvascular alterations, and immunologic abnormalities. We describe two cases of patients with hemiplegia who developed Raynaud׳s phenomenon and skin fibrosis of the non-paretic limb. METHODS:Clinical, laboratory, and investigation findings of two cases with hemiplegia who developed scleroderma spectrum disorders of the non-paretic limb are presented. A review of the medical literature was performed in PubMed for all articles in English. RESULTS:A total of 46 reports from 1935 to 2012 were identified, especially on osteoarthritis and rheumatoid arthritis. Only two case reports on patients with SSc describe asymmetric SSc skin involvement and unilateral acro-osteolysis on x-ray images of the non-paretic limb. By contrast, we report the first description of capillaroscopic microvascular changes in patients with hemiplegia and asymmetric SSc skin involvement. CONCLUSIONS:Our cases point out the potential role of a "cross-talk" between the nervous system and the skin in SSc-spectrum disorders and suggest future directions for research in studies of pathogenesis.

journal_name

Semin Arthritis Rheum

authors

Ughi N,Hervey SA,Gualtierotti R,Silvana Z,Herrick AL,Ingegnoli F,Meroni P

doi

10.1016/j.semarthrit.2014.10.011

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

597-601

issue

5

eissn

0049-0172

issn

1532-866X

pii

S0049-0172(14)00252-2

journal_volume

44

pub_type

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