Classification, categorization and essential items for digital ulcer evaluation in systemic sclerosis: a...

Area of Science:

• Rheumatology
• Dermatology
• Clinical Research

Background:

• A consensus exists for defining digital ulcers (DUs) in systemic sclerosis (SSc), but evaluation, classification, and categorization methods are lacking.
• This study aimed to identify essential DU evaluation items and assess proposed classification and categorization systems for SSc patients.

Purpose of the Study:

• To identify essential items for digital ulcer (DU) evaluation in systemic sclerosis (SSc).
• To assess the utility and feasibility of existing DU classification systems in clinical practice.
• To investigate the preference for a new DU categorization (episodic, recurrent, chronic) over a simple recurrent/not recurrent distinction.

Main Methods:

• The DeSScipher European multicentre study, specifically observational trial 1 (OT1) on DU management, surveyed EUSTAR centres.
• Online questionnaires assessed the completion rate of essential DU items and gathered feedback on the feasibility and usefulness of proposed DU classifications and categorizations.

Main Results:

• Eighty-four EUSTAR centres (56.8%) responded, identifying the number of DUs with tissue loss, recurrent DUs, and new DUs as essential evaluation items (≥70% agreement).
• The proposed DU classification was deemed useful and feasible by 65% of centres.
• A significant majority (80%) preferred the new episodic, recurrent, and chronic DU categorization over the simple recurrent/not recurrent distinction.

Conclusions:

• EUSTAR centres identified three key items for DU evaluation in SSc clinical practice.
• The proposed DU classification and categorization systems were considered useful and feasible, warranting further implementation and validation.