Dynamics of digital ulcers in systemic sclerosis

Abstract

Systemic sclerosis (SSc) is a collagenosis with insufficiently known etiopathogenesis, characterized by microvasculopathy and excessive fibrosis in the context of an autoimmune disorder. The incompletely elucidated pathogenesis and limited therapeutic options, disabling aspects, skin lesions and pain determine important functional and psychological deficiencies which affect the quality of life. It is imperative to observe and correlate individual clinical and paraclinical data to optimize disease management. A group of 22 patients diagnosed with SSc, hospitalized in a university clinic in Bucharest was included in an observational study. The evolution of digital ulcers was evaluated as an indicator of vasculopathy and their status and dynamics were correlated with clinical elements reflecting the fibrotic aspect of the disease. The present study shows that the Raynaud phenomenon is almost always present during the course of the disease, but its presence is not always associated with digital ulcers. The existing data in the literature show that fibrosis is subsequent to vasculopathy, but this study did not reveal causality between these two aspects of pathogenesis. The presence of microstomia and digital contracture was identified in the presence of digital ulcers, but also in their absence. The etiopathogenic mechanisms with multiple unknown involved factors open the opportunity to investigate many aspects of SSc for optimal aiming of therapeutic interventions.

Predictive value of immunological markers in systemic sclerosis

“…Systemic sclerosis (SSc) is a connective tissue disease manifested through an altered microvascularization which is then followed by cutaneous and visceral fibrosis, in the context of autoimmune alteration (1). The etiopathogenesis of this autoimmune disease burdened by skin damage and a high degree of viscera involvement is yet insufficiently known (2)(3)(4)(5)(6)(7)(8)(9). Despite numerous studies, the therapeutic management remains unsatisfactory (6,(9)(10)(11)(12)(13)(14)(15)(16)(17).…”

“…The etiopathogenesis of this autoimmune disease burdened by skin damage and a high degree of viscera involvement is yet insufficiently known (2)(3)(4)(5)(6)(7)(8)(9). Despite numerous studies, the therapeutic management remains unsatisfactory (6,(9)(10)(11)(12)(13)(14)(15)(16)(17).…”

Epidemiological profile of systemic sclerosis in the southeast region of Romania

“…Systemic sclerosis (SSc), a connective tissue disorder with an insufficiently known etiopathogenesis, is characterized by cutaneous and visceral microvasculopathy followed by excessive fibrosis ( 1 , 2 ). Skin fibrosis is the defining clinical element of this disease and a major clinical criterion according to the 2013 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for systemic sclerosis, being present in most patients, with the exception of a small number of cases in which the subset systemic sclerosis sine scleroderma is present ( 3 ).…”

Etiological factors of systemic sclerosis in the southeast region of Romania

“…Systemic sclerosis (SSc) is a rare chronic autoimmune disease with high mortality rates (1). The severity of this disease stems from multiple organ morpho-functional damage with multiple complications: Ulcers, gangrene, pulmonary and myocardial fibrosis, pulmonary hypertension, scleroderma renal crisis, esophageal damage and malabsorption syndrome (2)(3)(4). Skin induration in SSc requires differential diagnosis with other sclerodermal diseases (5,6).…”