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Systemic sclerosis (SSc)-related digital ulcers (DUs) are painful and disabling,1–3 and DU burden is often the primary outcome measure in clinical trials of SSc-related digital vasculopathy.4 This is despite several studies showing a lack of agreement between rheumatologists as to what constitutes a DU.5–8
Objective outcome measures of SSc-related DUs for tracking change over time are therefore urgently required for clinical practice and research studies. The application of digital planimetry to clinical DU photographs has shown the possibility of fine-grained measurement of DU characteristics (area).9 Our aims were to (1) demonstrate the feasibility of patients with SSc-related DUs/digital lesions photographing their lesions using smartphone cameras, and (2) use digital planimetry-style software analysis on images collected from patients to measure and track lesion area as a marker of healing or progression.
Patients with SSc-related digital lesions (judged to be ulcers by an experienced clinician) were asked to photograph …
Handling editor Josef S Smolen
Contributors GD is responsible for study design, data collection, data analysis, and editing and approval of manuscript. TLM and JBM are responsible for data collection, and editing and approval of manuscript. AKM is responsible for study design, data analysis and editing and approval of manuscript. RA, KO, MD, CT and ALH responsible for study design and editing and approval of manuscript.
Funding This study was funded by Manchester: Integrating Medicine and Innovative Technology.
Competing interests None declared.
Patient consent Obtained.
Ethics approval West Midlands (Edgbaston) Research Ethics Committee (reference 14/WM/1272).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional unpublished data from the study have been made available.