Association of skin hyperpigmentation disorders with digital ulcers in systemic sclerosis: Analysis of a cohort of 239 patients - 14/01/19
on behalf of the
Fédération Hospitalo-Universitaire–Aquitaine's Care and Research Organisation for Inflammatory and Immune-Mediated Diseases
Abstract |
Background |
Skin pigmentation disorders in systemic sclerosis (SSc) have been sparsely described in the literature. Nevertheless, they could be a diagnostic and/or severity marker.
Objectives |
To assess the association between pigmentation disorders and systemic involvement in patients with SSc.
Methods |
A total of 5 patterns of skin pigmentation disorders were defined: diffuse hyperpigmentation; hyperpigmentation of sun-exposed areas; hypopigmentation of the head, neck, and/or upper part of the chest; acral hypopigmentation; and diffuse hypopigmentation.
Results |
A total of 239 patients were included; 88 patients (36.8%) had skin pigmentation disorders as follows: diffuse hyperpigmentation and hyperpigmentation of sun-exposed areas in 38.6% (n = 34) and 27.3% (n = 24) of patients, respectively; hypopigmentation of the face, neck, and/or chest in 10.2% of patients (n = 9); diffuse hypopigmentation in 12.5% (n = 11); and acral hypopigmentation in 17% (n = 15). Diffuse hyperpigmentation was associated with diffuse SSc (P = .001), increased modified Rodnan skin score (P = .001), and shorter duration of Raynaud phenomenon (P = .002) in univariate analysis but not in multivariate analysis. Moreover, diffuse hyperpigmentation was associated with digital ulcers (P = .005), as confirmed by multivariate analysis (odds ratio, 2.96; 95% confidence interval, 1.28-6.89).
Limitations |
This was a single-center retrospective study of a cohort of patients with SSc.
Conclusion |
Screening for skin pigmentation disorders could be useful in the management of patients with SSc to identify those with a high risk of development of digital ulcers, which is a symptom of vascular involvement in SSc.
Le texte complet de cet article est disponible en PDF.Key words : digital ulcers, pigmentation, systemic sclerosis
Abbreviations used : DSSc, ET-1, MRSS, RP, SSc
Plan
Dr Leroy and Dr Henrot contributed equally to this study, and Dr Truchetet and Dr Seneschal contributed equally to this study. |
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Funding sources: None. |
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Conflicts of interest: None disclosed. |
Vol 80 - N° 2
P. 478-484 - février 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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