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Impact of digital ulcers on disability and health-related quality of life in systemic sclerosis
  1. Luc Mouthon (luc.mouthon{at}cch.aphp.fr)
  1. Paris Descartes University, COchin Hospital, France
    1. Caroline Mestre-Stanislas (carolinestanislas{at}yahoo.fr)
    1. Paris Descartes University, COchin Hospital, France
      1. Alice Bérezné (alice.berezne{at}cch.aphp.fr)
      1. Paris Descartes University, COchin Hospital, France
        1. François Rannou (francois.rannou{at}cch.aphp.fr)
        1. Paris Descartes University, COchin Hospital, France
          1. Philippe Guilpain (philippe.guilpain{at}cch.aphp.fr)
          1. Paris Descartes University, COchin Hospital, France
            1. Michel Revel (michel.revel{at}cch.aphp.fr)
            1. Paris Descartes University, COchin Hospital, France
              1. Christian Pagnoux (christian.pagnoux{at}cch.aphp.fr)
              1. Paris Descartes University, COchin Hospital, France
                1. Loïc Guillevin (loic.guillevin{at}cch.aphp.fr)
                1. Paris Descartes University, COchin Hospital, France
                  1. Jacques Fermanian (jacques.fermanian{at}nck.aphp.fr)
                  1. Department of Biostatistics Necker Hospital, France
                    1. Serge Poiraudeau (serge.poiraudeau{at}cch.aphp.fr)
                    1. Paris Descartes University, COchin Hospital, France

                      Abstract

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

                      Methods: We evaluated 213 SSc patients at 4 annual meetings of a patient society between 2004 and 2007 (177) or during hospital stay (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 (31.4%) patients 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 (1.218±0.723 vs. 0.930±0.717, p=0.008), CHFS (27.38±20.68 vs. 16.73±18.19, p<0.0001) and aesthetic prejudice (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 (Kapandji score 75.3±22.8 vs 81.7±19.2, p<0.0001). The presence of a DU did not alter significantly the physical component, but influenced the mental component (43.38±12.53 vs 39.58±9.54, p=0.026) of the SF36.

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

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