Portal de Periódicos da CAPES

Digital ulcers in scleroderma: staging, characteristics and sub-setting through observation of 1614 digital lesions

2010; Oxford University Press; Volume: 49; Issue: 7 Linguagem: Inglês

10.1093/rheumatology/keq097

1462-0332

Laura Amanzi, Francesca Braschi, G. Fiori, Felice Galluccio, Irene Miniati, Serena Guiducci, Ml Conforti, O. Kaloudi, Francesca Nacci, O. Sacu, Antonio Candelieri, Alberto Moggi Pignone, Laura Rasero, Domenico Conforti, M. Matucci-Cerinic,

Mast cells and histamine

To evaluate in SSc, the frequency of digital lesions and the morphology, characteristics, natural course and time to healing of 1614 digital ulcers (DUs).One hundred SSc patients were followed up for 4 years. In the first step, the digital lesions were observed and classified at the time of presentation [digital pitting scar (DPS); DU; calcinosis; gangrene]. In the second step, DUs were divided into subsets according to their origin and main features. In the third step, the time to healing was recorded for each DU and the influence of DU main characteristics on time to healing was also evaluated.In the first step, 1614 digital lesions were observed: DPS, 712 (44.1%) lesions; DU, 785 (48.6%); calcinosis, 110 (6.8%); and gangrene, 7 (0.8%). In the second step, DUs were subsetted as follows: DU developed on DPS (8.8%), pure DU; DU developed on calcinosis (60%); DU derived from gangrene. In the third step, the mean time to healing was 25.6 (15.6) days in DPS, 76.2 (64) days in pure DU, 93.6 (59.2) days in calcinosis ulcers and 281.1 (263.3) in gangrene.In SSc, digital lesions are represented by DPS, DU, calcinosis and gangrene, and provide an evidence-based DU subsetting according to their origin and main characteristics. Subsetting may be helpful for a precise DU evaluation and staging, and in randomized controlled trials for a precise identification of those DUs that are to be included in therapeutic studies.