Rheumatology Medical News about systemic sclerosis;capillaroscopic skin ulcer risk index; prognostic tool;digital skin ulcer development

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Capillaroscopic skin ulcer risk index: A new prognostic tool for digital skin ulcer development in systemic sclerosis patients
Arthritis Care and Research , 05/04/09

Sebastiani M et al. - The proposed capillaroscopic skin ulcer risk index (CSURI) may represent a novel tool with the ability to predict the development of digital ulcers in patients with scleroderma.

Methods

Study to develop a CSURI that can predict the onset of new digital ulcers by using nailfold videocapillaroscopy (NVC) in pts with SSc
NVC was performed in 120 pts (13 men; mean age 56.1 yrs, mean SSc duration 44.7 mo) to assess:
- total number of capillaries in distal row (N)
- maximum loop diameter (D)
- number of megacapillaries (M), and
- the M:N ratio

Results

Within 3 mo since NVC examination, 35/120 pts experienced digital ulcers
An association between ischemic lesions and the M:N ratio, N, and D was observed
An AUC 0.926 was shown for ulcer appearance, with specificity and sensitivity of 85.9% and 94.3%, respectively, at the cutoff value of 2.94
33/35 pts with new skin ulcers had a CSURI >2.94, but only 2/35 had a CSURI 2.94

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