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Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis

S I Nihtyanova1, G M Brough, C M Black

  • 1Centre for Rheumatology, Royal Free Hospital, Pond Street, London NW3 2QG, UK.

Annals of the Rheumatic Diseases
|July 31, 2007
PubMed

Insights

Severe digital vasculopathy (SDV) affects 17.4% of systemic sclerosis (SSc) patients, particularly those with diffuse cutaneous SSc. This complication often requires significant hospital-based treatment, highlighting its clinical burden.

Area of Science:

  • Rheumatology
  • Vascular Medicine
  • Dermatology

Background:

  • Vascular damage is a primary pathology in systemic sclerosis (SSc).
  • Severe digital vasculopathy (SDV) is a significant complication contributing to morbidity in SSc patients.
  • Understanding the clinical burden of SDV is crucial for managing SSc.

Purpose of the Study:

  • To assess the clinical burden of severe digital vasculopathy (SDV) in a large systemic sclerosis (SSc) cohort.
  • To review hospital-based treatments for SDV complications in SSc patients.
  • To identify the frequency and characteristics of SDV in different SSc subsets.

Main Methods:

  • Retrospective review of 1168 SSc patients over 18 months.
  • Identification of patients with SDV complications (digital ulceration, critical ischemia, gangrene).
  • Analysis of hospital admissions for treatments like IV prostacyclin, CGRP, antibiotics, amputation, or sympathectomy.

Main Results:

  • 17.4% of the SSc cohort experienced SDV-related complications.
  • SDV was significantly more frequent in diffuse cutaneous SSc (27.5%) than limited cutaneous SSc (13%).
  • 16.6% had digital ulcers, and 12% required IV prostacyclin/CGRP treatment, totaling 242 admissions (mean 6 days).

Conclusions:

  • Severe digital vasculopathy is a serious complication of systemic sclerosis.
  • SDV contributes significantly to patient morbidity and frequently necessitates hospital-based management.
  • The clinical burden of SDV in SSc warrants further investigation and optimized treatment strategies.
Abstract

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