Skin outcomes in limited systemic sclerosis: data of tertiary center

Detalhes bibliográficos
Autor(a) principal: Castro, Inês Ferrão Bagnari de
Data de Publicação: 2019
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10316/89861
Resumo: Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina
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spelling Skin outcomes in limited systemic sclerosis: data of tertiary centerEvolução da pele na Esclerose Sistémica Limitada: dados de um hospital terciárioEsclerose SistémicaEsclerose Sistémica LimitadaPeleEspessuraRodnan skin score modificadosystemic sclerosislimited cutaneous systemic sclerosisskinthicknessmodified Rodnan skin scoreTrabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaIntroduction: Systemic sclerosis (SSc) is a heterogeneous autoimmune disorder of unknown aetiology, which may involve the skin and internal organs to varying degrees and with different courses. The extent of skin involvement has a major impact on disease prognosis in the diffuse cutaneous subtype of SSc. However, there is scarce data regarding skin course in the limited cutaneous form (lcSSc). Our aims were to investigate skin involvement courses, and identify predictors for these courses, in lcSS patients.Methods: We performed a retrospective analysis including patients with lcSSc fulfilling the 2103 ACR/EULAR Classification Criteria for Systemic Sclerosis. Skin improvement, progression or stable course was defined by a cut-off of 3.5 points change in mRSS from baseline to last appointment. The European Scleroderma Trial and Research group Disease Activity Index (EUSTAR-DAI), clinical and laboratorial features were assessed. Baseline characteristics were compared between groups using chi-square and independent samples t-test, as appropriate. Logistic regression analysis was performed to identify possible predictive factors associated with skin course involvement.Results: We included 71 lcSSc patients [87.2% female, mean age at diagnosis 55.7 (SD 11.6) years]. The mean follow-up time was 15.5±9.2 years from baseline to last appointment. Maintenance of mRSS was observed in 65.2% (n=45), improvement in 27.6% (n=21) and progression in 7.2% (n=5) of the patients. A high baseline mRSS was associated with an improvement course (p<0.001). LcSSc patients with an inactive disease (EUSTAR-DAI<2.5) at baseline tend to have a stable mRSS course (p=0.001). In multivariate analysis, a high baseline skin score was predictor of skin improvement course during the follow-up (OR [95 IC]: 21.44 [5.86-78.49], p<0.001).Conclusions: LcSSc patients with advanced skin fibrosis at baseline are more likely to improve skin score than patients with milder skin fibrosis. Recognizing distinct patterns of mRSS course could help tailoring clinical management and cohort enrichment. Studies with a larger sample size will be needed to shed some light on skin involvement and its prognostic value in lcSSc.Introduction: Systemic sclerosis (SSc) is a heterogeneous autoimmune disorder of unknown aetiology, which may involve the skin and internal organs to varying degrees and with different courses. The extent of skin involvement has a major impact on disease prognosis in the diffuse cutaneous subtype of SSc. However, there is scarce data regarding skin course in the limited cutaneous form (lcSSc). Our aims were to investigate skin involvement courses, and identify predictors for these courses, in lcSS patients.Methods: We performed a retrospective analysis including patients with lcSSc fulfilling the 2103 ACR/EULAR Classification Criteria for Systemic Sclerosis. Skin improvement, progression or stable course was defined by a cut-off of 3.5 points change in mRSS from baseline to last appointment. The European Scleroderma Trial and Research group Disease Activity Index (EUSTAR-DAI), clinical and laboratorial features were assessed. Baseline characteristics were compared between groups using chi-square and independent samples t-test, as appropriate. Logistic regression analysis was performed to identify possible predictive factors associated with skin course involvement.Results: We included 71 lcSSc patients [87.2% female, mean age at diagnosis 55.7 (SD 11.6) years]. The mean follow-up time was 15.5±9.2 years from baseline to last appointment. Maintenance of mRSS was observed in 65.2% (n=45), improvement in 27.6% (n=21) and progression in 7.2% (n=5) of the patients. A high baseline mRSS was associated with an improvement course (p<0.001). LcSSc patients with an inactive disease (EUSTAR-DAI<2.5) at baseline tend to have a stable mRSS course (p=0.001). In multivariate analysis, a high baseline skin score was predictor of skin improvement course during the follow-up (OR [95 IC]: 21.44 [5.86-78.49], p<0.001).Conclusions: LcSSc patients with advanced skin fibrosis at baseline are more likely to improve skin score than patients with milder skin fibrosis. Recognizing distinct patterns of mRSS course could help tailoring clinical management and cohort enrichment. Studies with a larger sample size will be needed to shed some light on skin involvement and its prognostic value in lcSSc.2019-06-112025-06-09T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesishttp://hdl.handle.net/10316/89861http://hdl.handle.net/10316/89861TID:202478254engCastro, Inês Ferrão Bagnari deinfo:eu-repo/semantics/embargoedAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-27T10:56:28Zoai:estudogeral.uc.pt:10316/89861Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:10:04.877168Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Skin outcomes in limited systemic sclerosis: data of tertiary center
Evolução da pele na Esclerose Sistémica Limitada: dados de um hospital terciário
title Skin outcomes in limited systemic sclerosis: data of tertiary center
spellingShingle Skin outcomes in limited systemic sclerosis: data of tertiary center
Castro, Inês Ferrão Bagnari de
Esclerose Sistémica
Esclerose Sistémica Limitada
Pele
Espessura
Rodnan skin score modificado
systemic sclerosis
limited cutaneous systemic sclerosis
skin
thickness
modified Rodnan skin score
title_short Skin outcomes in limited systemic sclerosis: data of tertiary center
title_full Skin outcomes in limited systemic sclerosis: data of tertiary center
title_fullStr Skin outcomes in limited systemic sclerosis: data of tertiary center
title_full_unstemmed Skin outcomes in limited systemic sclerosis: data of tertiary center
title_sort Skin outcomes in limited systemic sclerosis: data of tertiary center
author Castro, Inês Ferrão Bagnari de
author_facet Castro, Inês Ferrão Bagnari de
author_role author
dc.contributor.author.fl_str_mv Castro, Inês Ferrão Bagnari de
dc.subject.por.fl_str_mv Esclerose Sistémica
Esclerose Sistémica Limitada
Pele
Espessura
Rodnan skin score modificado
systemic sclerosis
limited cutaneous systemic sclerosis
skin
thickness
modified Rodnan skin score
topic Esclerose Sistémica
Esclerose Sistémica Limitada
Pele
Espessura
Rodnan skin score modificado
systemic sclerosis
limited cutaneous systemic sclerosis
skin
thickness
modified Rodnan skin score
description Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina
publishDate 2019
dc.date.none.fl_str_mv 2019-06-11
2025-06-09T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10316/89861
http://hdl.handle.net/10316/89861
TID:202478254
url http://hdl.handle.net/10316/89861
identifier_str_mv TID:202478254
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/embargoedAccess
eu_rights_str_mv embargoedAccess
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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