Skin ulcers in systemic sclerosis: determinants of presence and predictive factors of healing
| Autor: | Stefano, Alivernini, Maria, De Santis, Barbara, Tolusso, Alice, Mannocci, Silvia Laura, Bosello, Giusy, Peluso, Michela, Pinnelli, Graziella, D'Antona, Giuseppe, La Torre, Giuseppe, LaTorre, Gianfranco, Ferraccioli |
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| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Systemic disease Settore MED/16 - REUMATOLOGIA Neovascularization Physiologic wound healing Dermatology Disease Systemic inflammation Thrombophilia Scleroderma metabolic syndrome smoking skin ulcers male middle aged medicine risk factors scleroderma humans nails Scleroderma Systemic integumentary system business.industry skin ulcer adult physiologic biomarkers Odds ratio Skin ulcer systemic medicine.disease Connective tissue disease follow-up studies predictive value of tests Surgery aged comorbidity female logistic models neovascularization physiologic scleroderma systemic Systemic sclerosis medicine.symptom neovascularization business |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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