Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis. Issue 1 (27th July 2007)

• Record Type: Journal Article
• Authors: Nihtyanova, S I; Brough, G M; Black, C M; Denton, C P
• Is Part Of: Annals of the rheumatic diseases. Volume 67:Issue 1(2008)
• Page Start: 120
• Page End: 123
• Publication Date: 2007-07-27
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/ard.2007.072686
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Vascular damage is a key pathological process in systemic sclerosis (SSc) and accounts for significant disease-related morbidity. To determine the clinical burden of severe digital vasculopathy (SDV), we have reviewed hospital-based treatment for this important complication of SSc in a large single centre cohort. Methods: Cases were identified from a cohort of 1168 patients with a diagnosis of SSc who were reviewed during an 18-month period. Patients with recorded episodes of SDV-related complications (digital ulceration, critical digital ischaemia or digital gangrene), requiring surgical amputation, digital sympathectomy or admissions for intravenous prostacyclin or calcitonin gene related peptide (CGRP) and/or intravenous antibiotic treatment were identified. Results: From this large SSc cohort, 17.4% had SDV-related complications. Contrary to expectation, their frequency was significantly higher among the patients with the diffuse cutaneous subset of SSc (27.5%) compared with 13% among the patients with limited cutaneous SSc (p<0.0001). 16.6% had at least one recorded episode of digital ulcers, and 12% required at least one hospitalisation during the 18 months for treatment with intravenous prostacyclin/CGRP. Overall, there were 242 admissions with a mean duration of 6 days. Conclusions: Digital vasculopathy is a serious complication of SSc contributing significant morbidity and often requiring hospital-based management.