Background Foot involvement can be a source of morbidity and disability in patients with systemic sclerosis (SSc). Some studies have previously reported severity, echographic and radiographic manifestations of foot involvement in SSc (1,2).
Objectives The aim of our study was to assess the nature and prevalence of foot problems in patients with SSc reporting a single centre experience.
Methods A podiatrist and a rheumatologist assessed 81 (76 female) consecutive patients attending our SSc outpatient clinic. The mean age was 50 years (range 21–70). Thirteen (16%) had diffuse cutaneous SSc with a median disease duration from Raynaud's Phenomenon of 5 years (range 3 –19); 68 (84%) had limited cutaneous SSc with a median disease duration of 11.5 years (range 1–41). The overall median disease duration was 11 years (range 1–41). Thirty (37%) were anticentromere antibodies positive, thirty five (43%) anti-scl70 antibodies positive. The two investigators evaluated the presence of the following features: colour changes, pain, previous ulceration, current ulceration, pre-ulceration (discoloration and thinning of the skin), toenail changes, hyperkeratosis, calcinosis, onychomycosis, dry skin, skin sclerosis, warts, scleredema, flatfoot. The presence of paresthesias, cramps, metatarsalgia were also investigated.
Results The diagram reports the prevalence of foot manifestations in the 81 SSc patients.
Most SSc patients suffer from symptoms related to their feet, particularly dry skin (70%), hyperkeratosis (plantar 58%, finger V 63%), Raynaund's phenomenon (59%), cramps (55%). No statistically significant differences were found between diffuse and limited SSc groups.
Conclusions Our study suggests that, in patients with SSc, foot problems are common and potentially disabling. A careful assessment of the feet should always be performed in these patients, in order to identify problems at an early stage.
La Montagna G et al. Semin Arthritis Rheum 2002.
Sari-Kouzel H et al. Rheumatology (Oxford) 2001.
Disclosure of Interest None declared