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Digital ulcers in systemic sclerosis: role of flow-mediated dilatation and capillaroscopy as risk assessment tools

  • Investigative Report
  • Published:
European Journal of Dermatology Aims and scope

Abstract

Aim

The aim of this study was to evaluate macrovascular endothelial dysfunction and microvascular damage as clinical markers of peripheral microangiopathy in patients with Raynaud’s phenomenon (RP).

Patients and methods

Seventy-seven secondary RP with systemic sclerosis, 32 primary RP and 34 healthy controls were included in our study. Secondary RP patients were divided into two subgroups: 39 with digital ulcers (DU) and 38 without digital ulcers (non-DU).

Results

Patients with DU had significantly lower flow-mediated dilatation values (5.34 ± 7.49%) compared to non-DU patients (16.21 ± 11.31%), primary RP (17.96 ± 12.78%) and controls (20.17 ± 8.86%), p<0.001, favouring macrovascular endothelium dysfunction. Regarding microvascular damage, the DU group had a predominately capillaroscopic late pattern (71.1%) whereas non-DU patients had an active pattern (56.4%). The microangiopathy evolution score was significantly higher in the DU group compared to the non-DU group (4.79 ± 1.82 vs. 1.79 ± 1.56, p<0.001). Flow-mediated dilation was significantly lower in late pattern (6.13 ± 7.09%) compared to active (12.58 ± 10.66%) and early patterns (17.72 ± 14.90%), p = 0.016 and p = 0.044 respectively.

Conclusions

Low flow-mediated dilatation and microvascular damage in capillaroscopy are early clinical markers of DU risk in RP patients.

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Author information

Authors and Affiliations

  1. Angiology, Vascular Surgery Service, Clinical Immunology Unit, Universidade do Porto, Porto, Portugal

    Ivone Silva

  2. Angiology and Vascular Surgery Service, Universidade do Porto, Porto, Portugal

    Tiago Loureiro & Rui Almeida

  3. Health Information and Decision Sciences Department, Universidade do Porto, Porto, Portugal

    Andreia Teixeira

  4. Clinical Immunology Unit, Centro Hospitalar do Porto, Praça da Revista o Tripeiro, n◦ 42, hab 23, 4415-789, Porto, Portugal

    Isabel Almeida & Carlos Vasconcelos

  5. Unit of Angiology and Vascular Surgery, Faculty of Medicine of University of Porto, Porto, Portugal

    Armando Mansilha

Authors
  1. Ivone Silva
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  2. Tiago Loureiro
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  3. Andreia Teixeira
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  4. Isabel Almeida
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  5. Armando Mansilha
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  6. Carlos Vasconcelos
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  7. Rui Almeida
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Correspondence to Ivone Silva.

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Silva, I., Loureiro, T., Teixeira, A. et al. Digital ulcers in systemic sclerosis: role of flow-mediated dilatation and capillaroscopy as risk assessment tools. Eur J Dermatol 25, 444–451 (2015). https://doi.org/10.1684/ejd.2015.2605

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  • DOI: https://doi.org/10.1684/ejd.2015.2605

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