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Bohelay, Gérôme; Blaise, Sophie; Levy, Pierre; Claeys, Antoine; Baudot, Nathalie; Cuny, Jean-Francois; Maillard, Hervé; Granel-Brocard, Florence; Boyé, Thierry; Lok, Catherine; Bénéton, Nathalie; Francès, Camille; Senet, Patricia
Acta dermato-venereologica, 2018, Volume: 98, Issue: 7Journal Article
Lower-limb ulcers in systemic sclerosis patients are rarely reported. The aim of this study was to describe the main causes and outcomes of lower-limb ulcers in systemic sclerosis patients and to assess factors associated with ischemic causes (arterial disease and/or microvascular impairment). A retrospective, multicentre, case-control study was conducted in 2013 and 2014, including 45 systemic sclerosis patients presenting lower-limb ulcers between 2008 and 2013. The estimated prevalence of lower-limb ulcers among systemic sclerosis patients was 12.8%. Ulcers were related to venous insufficiency in 22 cases (49%), ischemic causes in 21 (47%) and other causes in 2 (4%). Complete healing was observed in 60% of cases in a mean time of 10.3 months; 59% relapsed during a mean follow-up of 22 months. Ischemic lower-limb ulcers outcomes were poor, with a 28.6% amputation rate. Logistic-regression multivariate analyses between ischemic lower-limb ulcers cases and matched systemic sclerosis-controls identified past or concomitant digital ulcer and cutaneous sclerosis of the feet as independent risk factors associated with ischemic lower-limb ulcers.
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