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Pitting scars in progressive systemic sclerosis

M Maeda1, K Matubara, H Hirano

  • 1Department of Dermatology, Gifu University School of Medicine, Japan.

Dermatology (Basel, Switzerland)
|January 1, 1993
PubMed
Summary

Digital pitting scars are common in progressive systemic sclerosis (PSS). These scars, characterized by hyperkeratosis, are linked to PSS symptoms and may be caused by external factors like cold exposure.

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Area of Science:

  • Dermatology
  • Rheumatology
  • Pathology

Background:

  • Digital pitting scars are a frequent clinical manifestation in patients diagnosed with progressive systemic sclerosis (PSS).
  • The exact cause and pathological mechanisms underlying these digital lesions remain incompletely understood.
  • These scars can potentially lead to minor ulcerations, impacting patient well-being.

Purpose of the Study:

  • To investigate the clinical and histological characteristics of digital pitting scars in patients with PSS.
  • To determine the prevalence and anatomical distribution of these scars.
  • To explore potential associations between digital pitting scars and other PSS manifestations.

Main Methods:

  • A cohort of 87 patients with PSS was prospectively evaluated annually.

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  • Digital pitting scars were clinically defined as pinhole-sized, concave depressions with hyperkeratosis.
  • Histopathological analysis of biopsy samples from three patients provided insights into the scar's microscopic features.

    • Main Results:

    • Pitting scars were identified in 39% (34 out of 87) of the PSS patients.
    • Scars were observed on fingertips, finger sides (radial and ulnar borders), and over digital joints (proximal interphalangeal and metacarpophalangeal).
    • A significant association was found between pitting scars and Raynaud's phenomenon, skin thickening, and joint involvement.

    Conclusions:

    • Digital pitting scars are a prevalent sign in PSS, closely correlating with disease activity and other symptoms.
    • Histological examination revealed hyperkeratosis, altered collagen, and inflammation.
    • The distribution of scars suggests that external factors such as trauma, vibration, and cold exposure may contribute to their development.