Ann Rheum Dis 1998;57:52-55 ( January )

Concise reports

Microvascular involvement in systemic sclerosis: laser Doppler evaluation of reactivity to acetylcholine and sodium nitroprusside by iontophoresis L La Civita, M Rossi, G Vagheggini, F A A Storino, L Credidio, G Pasero, C Giusti, C Ferri

Rheumatology Unit, UO Medicina II, Department of Internal Medicine, University of Pisa, Pisa, Italy

Correspondence to: Professor C Ferri, Rheumatology Unit, Ospedale S Chiara, via Roma 67, 56126 Pisa, Italy.

Accepted for publication 15 October 1997

OBJECTIVESTo investigate the skin vasodilatory response to iontophoretically applied acetylcholine (Ach), an endothelium dependent vasodilator, and to sodium nitroprusside (SNP), an endothelium independent vasodilator, in patients with systemic sclerosis (SSc).
METHODSEleven SSc patients were preliminarily studied (10 females, mean age 40.5; mean disease duration 6.5 years), and 16 age and sex matched control subjects. By means of laser Doppler flowmetry skin blood flow was evaluated at third finger, at baseline, and after post-ischaemic hyperaemia test and during iontophoretically transcutaneous application of 1% solution of Ach and SNP.
RESULTSNo significant differences in basal skin blood flow were detected between SSc patients and controls. Cutaneous vasodilatory response to ischaemia, Ach, and SNP was significantly less pronounced in SSc patients compared with controls (p<0.001). Moreover, among SSc patients a lower (p< 0.05) vasodilatory response to Ach compared with ischaemia and SNP was recorded.
CONCLUSIONSThese data confirm a reduction of skin digital vasodilatory reserve in SSc patients and suggest a defect of both endothelial dependent arteriolar relaxation and wall compliance in the pathogenesis of this dysfunction.

Keywords: systemic sclerosis; iontophoresis; endothelium; acetylcholine; sodium nitroprusside; post-ischaemic hyperaemia

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© 1998 by Annals of the Rheumatic Diseases
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