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Clinical characteristics and predictors of gangrene in patients with systemic sclerosis and digital ulcers in the Digital Ulcer Outcome Registry: a prospective, observational cohort
  1. Yannick Allanore1,
  2. Christopher P Denton2,
  3. Thomas Krieg3,
  4. Peter Cornelisse4,
  5. Daniel Rosenberg5,
  6. Barbara Schwierin6,
  7. Marco Matucci-Cerinic7
  8. on behalf of the DUO Investigators
  1. 1 Department of Rheumatology A, Cochin Hospital, Paris Descartes University, Paris, France
  2. 2 Centre for Rheumatology and Connective Tissue Diseases, Royal Free Hospital, London, UK
  3. 3 Department of Dermatology, University of Cologne, Cologne, Germany
  4. 4 Department of Biostatistics, Actelion Pharmaceuticals, Allschwil, Switzerland
  5. 5 Department of Epidemiology and Observational Studies, GCS & E, Actelion Pharmaceuticals, Allschwil, Switzerland
  6. 6 Department of Global Clinical Development and Epidemiology, Actelion Pharmaceuticals, Allschwil, Switzerland
  7. 7 Division of Rheumatology AOUC, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
  1. Correspondence to Professor Yannick Allanore, Service de Rhumatologie A, Hôpital Cochin, 27 rue du Faubourg Saint Jacques, Paris 75014, France; yannick.allanore{at}

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Digital vasculopathy in systemic sclerosis (SSc) consists of a spectrum of Raynaud's phenomenon (RP), digital ulcers (DUs), critical digital ischaemia and escalation to gangrene. The complications of severe digital vasculopathy often require hospital-based management with intravenous therapies and surgery.1–3 Although gangrene is not infrequent in the clinic, data on the prevalence and implications of gangrene in patients with SSc are scarce.3–7 The DU Outcomes (DUO) Registry is a European, prospective, multicentre, observational cohort of patients with SSc and past and/or current DUs at enrolment.8–10 The aims of the current study were (i) to describe the characteristics of an SSc–DU population according to the presence/history of gangrene and (ii) to identify the risk factors for the development of incident gangrene.

All patients in the participating centres with SSc and a history or presence of DUs are eligible for inclusion in the DUO Registry, irrespective of their treatment regimen. At enrolment, data were collected on demographic and clinical variables. Patients were categorised into three groups according to their past history of gangrene …

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