Geographic variation as a risk factor for digital ulcers in systemic sclerosis patients: a multicentre registry

Geographic variation as a risk factor for digital ulcers in systemic sclerosis patients: a multicentre registry

Author Souza, E. J. R. Google Scholar
Muller, C. S. Google Scholar
Horimoto, A. M. C. Google Scholar
Rezende, R. A. Google Scholar
Guimaraes, I. Google Scholar
Mariz, H. A. Google Scholar
Dantas, A. T. Google Scholar
Da Costa, I. P. Google Scholar
Del-Rio, A. P. T. Google Scholar
Sekiyama, J. Google Scholar
Kahwage, C. B. Google Scholar
Kayser, C. Autor UNIFESP Google Scholar
Abstract Objective: To evaluate the influence of geographic variation on the risk of digital ulcer (DU) development in systemic sclerosis (SSc) patients. Methods: This cross-sectional, multicentre study evaluated patients with SSc from centres located in different geographic regions of Brazil (subtropical and tropical climate zones). Demographic and clinical data were collected. Results: The study included 141 patients with SSc (26 from the subtropical and 115 from the tropical zone). In total, 43 DUs were observed in 23 (16%) of the patients. By a simple logistic regression model, the presence of DUs was associated with a higher modified Rodnan skin score, previous necrosis or amputation of the extremities, flexion contracture of the fingers, active smoking, higher avascular score on capillaroscopy, higher severity of Raynaud's phenomenon, a higher Health Assessment Questionnaire Disability Index (HAQ-DI) score, a higher visual analogue scale score for Raynaud's phenomenon and overall disease, and the subtropical climate zone. Using multiple logistic regression, the presence of DUs was significantly associated with patients living in the subtropical climate zone [odds ratio (OR)=5.4, p=0.002], necrosis or amputation (OR=5.2, p=0.011), and a higher HAQ-DI score (OR=2.6, p=0.021). Conclusion: In this multicentre study in a continental country with different climates, patients with SSc living in a subtropical climate region had a 5.4 times higher risk of developing DUs than patients living in a warmer region (tropical climate), suggesting a more severe course of peripheral vasculopathy among patients living in geographic regions with relatively cold weather.
xmlui.dri2xhtml.METS-1.0.item-coverage Abingdon
Language English
Date 2017
Published in Scandinavian Journal Of Rheumatology. Abingdon, v. 46, n. 4, p. 288-295, 2017.
ISSN 0300-9742 (Sherpa/Romeo, impact factor)
Publisher Taylor & Francis Ltd
Extent 288-295
Origin http://dx.doi.org/10.1080/03009742.2016.1233994
Access rights Closed access
Type Article
Web of Science ID WOS:000406121700005
URI https://repositorio.unifesp.br/handle/11600/55511

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