Digital laser doppler flowmetry may discriminate "limited" from "diffuse" systemic sclerosis

Area of Science:

• Vascular Biology
• Rheumatology
• Medical Diagnostics

Background:

• Systemic sclerosis (SSc) is a connective tissue disease characterized by microvascular dysfunction.
• Understanding microvascular changes is crucial for diagnosing and managing SSc and related conditions like primary Raynaud's phenomenon (PRP).

Purpose of the Study:

• To evaluate skin blood flux and microvascular function in SSc patients using laser Doppler flowmetry (LD).
• To compare microvascular responses to dynamic stimuli (cold test, post-occlusive hyperemia) between SSc patients, PRP patients, and healthy donors (HD).

Main Methods:

• Laser Doppler flowmetry (LD) was used to measure skin blood flux on the dorsal hands.
• Measurements were taken at baseline and after cold and post-occlusive hyperemia tests.
• The study included 59 SSc patients (limited and diffuse cutaneous), 25 PRP patients, and 31 HD.

Main Results:

• SSc patients exhibited a significantly greater reduction in blood flux after the cold test compared to PRP and HD.
• Within SSc, limited cutaneous SSc showed a significant cold test flux reduction, while diffuse cutaneous SSc did not.
• Diffuse cutaneous SSc patients had a prolonged recovery time after the occlusive test compared to limited SSc, PRP, and HD.

Conclusions:

• The findings indicate impaired vascular tone regulation in SSc, with distinct pathogenic mechanisms potentially underlying different SSc subsets.
• Laser Doppler flowmetry reveals distinct patterns between PRP and SSc-associated Raynaud's phenomenon (RP).
• Monitoring PRP patients using LD may help predict the development of SSc.