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Impact of digital ulcers on disability and health-related quality of life in systemic sclerosis
  1. L Mouthon1,
  2. C Mestre-Stanislas1,
  3. A Bérezné1,
  4. F Rannou2,
  5. P Guilpain1,
  6. M Revel2,
  7. C Pagnoux1,
  8. L Guillevin1,
  9. J Fermanian3,
  10. S Poiraudeau2
  1. 1
    Paris Descartes University, Faculty of Medicine, EA 4058, Department of Internal Medicine, Reference center for vasculitides and systemic sclerosis, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
  2. 2
    Paris Descartes University, Department of Rehabilitation, Cochin Hospital, AP-HP, Paris, INSERM Institut Féderatif de Recherche sur le Handicap (IFR 25), France
  3. 3
    Department of Biostatistics, AP-HP, Necker Hospital, Paris-Descartes University, Paris, France
  1. Correspondence to Dr L Mouthon, Department of Internal Medicine, Cochin Hospital, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France; luc.mouthon{at}cch.aphp.fr

Abstract

Objective: To assess the impact of digital ulcers (DUs) on disability and health-related quality of life (HRQoL) in systemic sclerosis (SSc).

Methods: Two hundred and thirteen patients with SSc were evaluated at four annual meetings of a patient society between 2004 and 2007 (n = 177) or during hospital stay (n = 36). HRQoL was assessed by the SF-36, global disability by the health assessment questionnaire (HAQ), hand disability by the Cochin Hand Function Scale (CHFS) and global hand and wrist mobility by the Kapandji index.

Results: Sixty-seven patients (31.4%) had at least one DU at the time of evaluation. Patients with DUs showed significantly more pitting scars (p<0.001) and calcinosis (p<0.0001) than others. Patients with DU had significantly greater HAQ (mean (SD) 1.218 (0.723) vs 0.930 (0.717), p = 0.008), CHFS (mean (SD) 27.38 (20.68) vs 16.73 (18.19), p<0.0001) and aesthetic prejudice (mean (SD) 6.1 (2.2) vs 3.9 (2.5), p<0.0001) scores than others. Hand and wrist mobility were significantly diminished in patients with DU (mean (SD) Kapandji score 75.3 (22.8) vs 81.7 (19.2), p<0.0001). The presence of a DU did not significantly alter the physical component but influenced the mental component (mean (SD) 43.38 (12.53) vs 39.58 (9.54), p = 0.026) of the SF36.

Conclusion: Patients with SSc with DUs have reduced wrist and hand mobility, increased global and hand disabilities and decreased mental component of HRQoL.

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Footnotes

  • LM, AB and LG are members of the Groupe Français de Recherche sur la Sclérodermie.

  • Competing interests None.

  • LM, AB and LG are members of the Groupe Français de Recherche sur la Sclérodermie.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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