Lower Extremity Ulcers in Systemic Sclerosis: Features and Response to Therapy
Nondigital lower extremity ulcers are a difficult to treat complication of scleroderma, and a significant cause of morbidity. The purpose of this study was to evaluate the prevalence of nondigital lower extremity ulcers in scleroderma and describe the associations with autoantibodies and genetic pro...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi Limited
2010-01-01
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| Series: | International Journal of Rheumatology |
| Online Access: | http://dx.doi.org/10.1155/2010/747946 |
| Summary: | Nondigital lower extremity ulcers are a difficult to treat
complication of scleroderma, and a significant cause of morbidity.
The purpose of this study was to evaluate the prevalence of
nondigital lower extremity ulcers in scleroderma and describe the
associations with autoantibodies and genetic prothrombotic states.
A cohort of 249 consecutive scleroderma patients seen in the
Georgetown University Hosptial Division of Rheumatology was
evaluated, 10 of whom had active ulcers, giving a prevalence of
4.0%. Patients with diffuse scleroderma had shorter disease
duration at the time of ulcer development (mean 4.05 years ± 0.05)
compared to those with limited disease (mean 22.83 years ± 5.612, P value .0078).
Ulcers were bilateral in 70%. In the 10 patients
with ulcers, antiphospholipid antibodies were positive in 50%,
and genetic prothrombotic screen was positive in 70% which is
higher than expected based on prevalence reports from the general
scleroderma population. Of patients with biopsy specimens
available (n=5), fibrin occlusive vasculopathy was seen in 100%,
and all of these patients had either positive antiphospholipid
antibody screen, or positive genetic prothrombotic profile. We
recommend screening scleroderma patients with lower extremity
ulcers for the presence of anti-phospholipid antibodies and
genetic prothrombotic states. |
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| ISSN: | 1687-9260 1687-9279 |