Session Information
Date: Tuesday, November 10, 2015
Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's - Clinical Aspects and Therapeutics Poster III
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Peripheral blood perfusion is reduced in patients affected by both primary (PRP) or secondary Raynaud’s phenomenon (SRP) (1-2). The objective of this study was to investigate blood perfusion (BP) in different skin areas of patients with PRP, SRP to systemic sclerosis (SSc), and healthy subjects (CNT), looking for differences between the groups.
Methods: Seventy SSc patients (new ACR/EULAR criteria) (3) (mean age 63±12 years, mean disease duration 6±5 years), 31 PRP patients (LeRoy criteria) (4) (mean age 48±18 years, mean Raynaud duration 3±2 years) and 68 CNT (mean age 59±19 years) were enrolled during winter time, after informed consent. BP was assessed by Laser speckle contrast analysis (LASCA) at the level of fingertips, periungual areas, dorsal and palmar aspect of 3rd finger bilaterally, dorsum and palm of both hands, and the average BP calculated as perfusion units (PU) (1). Nailfold videocapillaroscopy (NVC) was also performed to distinguish between PRP and SRP, and to detect the proper pattern of nailfold microangiopathy (“early”, “active” or “late”) (5). Patients were not taking vasodilator drug since al least two weeks.
Results: Both PRP and SSc patients showed a statistically significant lower BP than CNT at the level of fingertips (median 86, 88, 186 PU, respectively, p<0.0001), periungual (median 75, 76, 142 PU, respectively, p<0.0001), palmar aspect of 3rd finger (median 71, 81, 134 PU, respectively, p<0.0001), and palm areas (median 61, 78, 112 PU, respectively, p<0.0001). On the contrary, the three groups displayed similar BP values at the level of other areas of hands. Of interest, PRP patients showed lower BP values than SSc patients in all areas of hand, even if BP was found statistically different only at the level of both palmar aspects of 3rd finger (p=0.04) and palm of hands (p=0.008). The gradients of BP fingertip-phalanx-palm and periungual-phalanx-dorsum were significantly lower in PRP than in SSc patients (p<0.0001), as well as significantly higher in CNT when compared with both PRP and SSc patients (p<0.0001). A statistically significant progressive decrease of BP was observed in SSc patients with progressive pattern of nailfold microangiopathy (“early”, “active”, and “late”) at the level of fingertips, periungual, palmar aspect of 3rd fingers and palm areas (p<0.05). Moreover, BP was significantly lower in PRP than in SSc patients with the “early” pattern of microangiopathy in all areas (p<0.04), with the exception of dorsal phalanx and hand dorsum.
Conclusion: By considering a small cohort of patients, BP of hand was found lower in PRP than in SSc patients with the “early” NVC pattern of microangiopathy. Also the gradients of perfusion between distal and proximal areas of hand were significantly lower in PRP than in SSc patients. The clinical value of this new early finding is matter of further analysis.
References: 1. Ruaro B, et al. Ann Rheum Dis 2014;73:1181-5. 2. Rosato E, et al. Rheumatology 2009;36:2257-63. 3. van den Hoogen F, et al. Ann Rheum Dis 2013; 72:1747-55. 4. LeRoy EC, et al. Clin Exp Rheumatol.1992;10:485-8. 5. Sulli A, et al. Arthritis Rheum. 2012;64:821-5.
To cite this abstract in AMA style:
Sulli A, Ruaro B, Trombetta AC, Smith V, Pizzorni C, Paolino S, Cutolo M. Blood Perfusion in Different Skin Areas of Hands in Primary Raynaud’s Phenomenon and Systemic Sclerosis Patients [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/blood-perfusion-in-different-skin-areas-of-hands-in-primary-raynauds-phenomenon-and-systemic-sclerosis-patients/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/blood-perfusion-in-different-skin-areas-of-hands-in-primary-raynauds-phenomenon-and-systemic-sclerosis-patients/