Bobeică C, Tatu AL, Crăescu M, Solovăstru L. Dynamics of digital ulcers in systemic sclerosis.
Exp Ther Med 2020;
20:61-67. [PMID:
32508995 PMCID:
PMC7271728 DOI:
10.3892/etm.2020.8572]
[Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/11/2020] [Indexed: 12/22/2022] Open
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.
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