| Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients. | |
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MedLine Citation:
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PMID: 19405007 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Digital ulcerations are one of the most frequent manifestations of microangiopathy in patients with systemic sclerosis (SSc; scleroderma). The early detection of SSc patients who are at high risk to develop digital ulcers could allow a preventive treatment of these complications with reduction of morbidity and social costs. The aim of our study was to develop a capillaroscopic skin ulcer risk index (CSURI) that can predict the onset of new digital ulcers by using nailfold videocapillaroscopy (NVC) in patients with SSc. METHODS: We performed NVC in 120 consecutive unselected patients with SSc (13 men, 107 women, mean +/- SD age 56.1 +/- 13.4 years, mean +/- SD SSc duration 44.7 +/- 60.7 months) to assess the total number of capillaries in the distal row (N), maximum loop diameter (D), number of megacapillaries (M), and the M:N ratio. RESULTS: Within 3 months since NVC examination, 35 of 120 patients experienced digital ulcers. A significant association between ischemic lesions and the M:N ratio, N, and D was observed; the combination of these parameters allowed us to develop the CSURI, which is characterized by the formula D x M:N(2). A receiver operating characteristic curve analysis showed an area under the curve of 0.926 for ulcer appearance, with specificity and sensitivity of 85.9% and 94.3%, respectively, at the cutoff value of 2.94. Interestingly, 33 of 35 patients with new skin ulcers had a CSURI >2.94, but only 2 of 35 had a CSURI < or =2.94. CONCLUSION: The proposed CSURI may represent a novel tool with the ability to predict the development of digital ulcers in patients with scleroderma. |
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Authors:
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M Sebastiani; A Manfredi; M Colaci; R D'amico; V Malagoli; D Giuggioli; C Ferri |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Arthritis and rheumatism Volume: 61 ISSN: 0004-3591 ISO Abbreviation: Arthritis Rheum. Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-13 Completed Date: 2009-06-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370605 Medline TA: Arthritis Rheum Country: United States |
Other Details:
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Languages: eng Pagination: 688-94 Citation Subset: AIM; IM |
Affiliation:
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University of Modena and Reggio Emilia, Modena, Italy. marco.sebastiani@unimore.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Humans Logistic Models Male Microcirculation / physiology* Microscopic Angioscopy / methods Middle Aged Predictive Value of Tests Prognosis ROC Curve Risk Factors Scleroderma, Systemic / complications*, diagnosis*, physiopathology Sensitivity and Specificity Severity of Illness Index* Skin / blood supply* Skin Ulcer / epidemiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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