TY - JOUR
T1 - Skin ulcers in systemic sclerosis
T2 - Determinants of presence and predictive factors of healing
AU - Alivernini, Stefano
AU - De Santis, Maria
AU - Tolusso, Barbara
AU - Mannocci, Alice
AU - Bosello, Silvia Laura
AU - Peluso, Giusy
AU - Pinnelli, Michela
AU - D'Antona, Graziella
AU - LaTorre, Giuseppe
AU - Ferraccioli, Gianfranco
PY - 2009/3
Y1 - 2009/3
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=60149109220&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=60149109220&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2008.11.025
DO - 10.1016/j.jaad.2008.11.025
M3 - Article
C2 - 19231640
AN - SCOPUS:60149109220
VL - 60
SP - 426
EP - 435
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
SN - 0190-9622
IS - 3
ER -