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See Latest ArticlesA score of risk factors associated with ischemic digital ulcers in patients affected by systemic sclerosis treated with iloprost
Clinical Rheumatology, 03/30/09
Caramaschi P et al. – Study shows that scleroderma patients with ischemic digital ulcers (DUs) are characterized by early disease onset, delay in beginning iloprost therapy, smoking habit, and presence of joint contraction. A score reflecting the sum of these factors may be useful to predict the risk of developing ischemic DUs.
Methods- Aim was to evaluate the incidence of DUs in SSc pts (n=85) treated with iloprost
- Characteristics between the pts with and w/o DUs were compared
- Ischemic DUs and scleroderma contracture ulcers were separately considered
- 29 subjects developed ischemic DUs during the course of the disease
- Scleroderma contracture ulcers occurred in 6
- Ischemic DUs were associated with:
- younger age at scleroderma onset
- a longer disease duration
- a longer time delay from scleroderma diagnosis to iloprost therapy
- a bigger skin involvement
- the presence of joint contractures
- a videocapillaroscopic late pattern
- a history of smoking
- and of corticosteroids therapy
- After the exclusion of 4 subjects with concomitant peripheral arterial disease, only 4 variables from the list above, shown in bold remained associated with ischemic DUs
- Prevalence of ischemic DUs increased progressively from the lowest to the highest value of the score
- All pts with scleroderma contracture ulcers were characterized by both diffuse pattern of disease and positivity for anti-Scl70 Ab
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