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AB0662 Systemic sclerosis (SSC) cohort in abu dhabi: focus on digital ulcers (DU)
  1. M Al-Maini1,
  2. H Al-Mashari1,
  3. T Khan1,
  4. N Abutaha1,
  5. R Aneja1,
  6. A Las Alas1,
  7. S Gonuguntla1,
  8. M Cerinic2,
  9. K Khawaja1
  1. 1Adult and Pediatric Rheumatology, Allergy and Immunology, Al-Mafraq Hospital, Abu Dhabi, United Arab Emirates
  2. 2Rheumatology, University of Florence, Florence, Italy

Abstract

Background DU are a significant burden for SSc patients affecting approximately 40–50% of patients (1). No data are available on the frequency of DU on SSC patients living in the United Arab Emirates.

Objectives To identify the frequency of DU in a cohort of SSC in Abu Dhabi which is the capital city of the United Arab Emirates (UAE).

Methods SSC patients identified according to ACR EULAR criteria through the hospital electronic medical records system, which was implemented from January 2011 for medical documentation in all public hospitals in Abu- Dhabi and districts. Using the International statistical classification of diseases and related health problems, usually called by the short form name international classification of Diseases (ICD), version 9 (710.1) from 1st of January 2011 to 31st of December 2016. Retrospective review of electronic medical records and paper case notes was performed on patients who presented during this period. The frequency of DU was searched. DU were defined (1) and categorised (2) (no digital ulcers, episodic (rarely recurrent), recurrent (frequently recurrent) and chronic (≥1 DU at every follow up). Results and the incidence of gangrene were compared to data from DUO registry (3).

Results 47 SSc patients (Male to female ratio 12 (25.5%) to 35 (74.5%) (Duration of disease from 2 to 24 years with peak age for ulcers between 40–50 years) were identified. No ulcers were detected in 34 patients (72.3%) while DU were found in 13 patients (27.7%): they were episodic in 9 patients (19%) and chronic in 4 patients (8.5%) of the total patients. No recurrent ulcers were found. Only one patient (2%) evolved to gangrene (she was a smoker). The other 12 patients with DU were non-smokers and three of them were under 16 years of age.

Conclusions In Abu Dhabi SSc population, the incidence of DU is 27.7%. This differs from the incidence in the western literature where it peaks from 40 to 50% (3). Our patients had episodic (19%) and chronic DU (8.5%) of the total patients. The incidence of gangrene in our cohort was lower when compared to the data reported in the DUO registry (20%) (2). Although patients live in a very warm climate, DU are still experienced in SSc in Abu Dhabi. Likely, the chronic exposure to air conditioning may explain this paradox.

References

  1. Suliman Y et al. Preliminary musculoskeletal ultrasound (MSUS) ulcer definition does not correlate with visual observation in systemic sclerosis (SSc) patients. J. scleroderma relat. disord. 2017 (in press).

  2. Matucci-Cerinic M et al. Elucidating the burden of recurrent and chronic digital ulcers in systemic sclerosis: long-term results from the DUO Registry. Ann Rheum Dis. 2016;75:1770–6.

  3. Allanore Y, Denton CP, Krieg T, etal.Clinical characteristics and predictosof gangrene in patients with systemic sclerosis and digital ulcers in Digital Ulcer Outcome Registry: a prospective, observational cohort. Ann Rheumatic Dis 2016;75:1736–1740.

References

Disclosure of Interest None declared

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