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. 2009 Mar;60(3):426-35.
doi: 10.1016/j.jaad.2008.11.025.

Skin ulcers in systemic sclerosis: determinants of presence and predictive factors of healing

Stefano Alivernini  1 , Maria De Santis, Barbara Tolusso, Alice Mannocci, Silvia Laura Bosello, Giusy Peluso, Michela Pinnelli, Graziella D'Antona, Giuseppe La Torre, Gianfranco Ferraccioli
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Skin ulcers in systemic sclerosis: determinants of presence and predictive factors of healing

Stefano Alivernini et al. J Am Acad Dermatol. 2009 Mar.

Erratum in

  • J Am Acad Dermatol. 2015 Apr;72(4):748. LaTorre, Giuseppe [Corrected to La Torre, Giuseppe]

Abstract

Background: Skin ulcers are common vascular complications of systemic sclerosis (SSc).

Objective: The aim of the study was to identify clinical, biologic, and imaging parameters that constitute risk factors for the occurrence and persistence of skin ulcers.

Methods: One hundred thirty Italian SSc patients were examined at entry and after 20 months of follow-up.

Results: The diffuse SSc phenotype with avascular areas on capillaroscopy, thrombophilia, and systemic inflammation as defined by interleukin 6 plasma levels, represented the major risk factors for ulcer development. Infection was associated with a risk of poor or no healing, and cardiopulmonary involvement was a major comorbid factor in patients with ulcers. The presence of infection and avascular areas represented the main determinants for ulcer healing.

Limitations: Our data should be confirmed with a longer follow-up period since skin ulcers represent a frequent vascular complication in scleroderma patients.

Conclusion: Aggressive therapies aiming at improving angiogenesis and controlling infection and the course of the disease appear to be crucial to obtain ulcer healing.

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