Lower Extremity Ulcers in Systemic Sclerosis: Features and Response to Therapy

Shanmugam, Victoria K., Price, Patricia Elaine, Attinger, Christopher E. and Steen, Virginia D. 2010. Lower Extremity Ulcers in Systemic Sclerosis: Features and Response to Therapy. International Journal of Rheumatology 2010 , 747946. 10.1155/2010/747946

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Abstract

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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences
Subjects:	R Medicine > RM Therapeutics. Pharmacology
Publisher:	Hindawi
ISSN:	1687-9260
Date of First Compliant Deposit:	30 March 2016
Last Modified:	23 May 2023 22:06
URI:	https://orca.cardiff.ac.uk/id/eprint/30627

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