Scleroderma

Digital ulcers are associated with more severe systemic sclerosis (SSc) disease, including skin and lung involvement, but not with pulmonary arterial hypertension (PAH) or scleroderma renal crisis (SRC), according to research published in the January issue of Arthritis Care & Research.

Sarit Khimdas, from the University of Western Ontario in London, Canada, and colleagues analyzed data from 938 patients with SSc who participated in the Canadian Scleroderma Research Group, which collects information from SSc patients annually. Data included the presence, position, and number of digital ulcers; complications; involvement of internal organs; skin score; and results from laboratory testing.

The investigators found that 8 percent of patients currently had a digital ulcer; 44 percent had had one in the past; and 53.1 percent had digital pitting scars. In limited cutaneous SSc and diffuse cutaneous SSc subsets, digital ulcers were associated with a higher disease burden, as evidenced by higher Rodnan skin scores, hand and finger scores, and worse hand function according to the Health Assessment Questionnaire score. Digital ulcers were also linked to longer disease duration, younger age at disease onset, interstitial lung disease, and topoisomerase I antibodies. No association was seen with sex, smoking, PAH, or SRC. In diffuse cutaneous SSc, digital ulcers were associated with reduced diffusing capacity for carbon monoxide and esophageal involvement.

"In conclusion, there are some associations with digital ulcers but a surprising lack of association between digital ulcers and other manifestations of structural vasculopathy, including PAH and SRC," the authors write.

Source: DoctorsLounge. Original article can be viewed here.