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Whole-body distribution and clinical association of telangiectases in systemic sclerosis

JAMA Dermatology May 19, 2018

Jouvray M, et al. - Authors ascertained the whole-body distribution of telangiectases (TAs) and evaluated the relationship between the whole-body TA number and the characteristics of patients with systemic sclerosis (SSc). The patients with SSc included in this study had TAs predominantly located on the face, hands, and the upper part of the trunk. Findings suggested an association of telangiectases with vasculopathy features of SSc, particularly with pulmonary hypertension (PH) and soluble endoglin levels.

Methods

  • Experts conducted a single-center, cross-sectional study between July 11, 2016, and March 15, 2017, at the National Referral Centre for Rare Systemic and Autoimmune Diseases in France.
  • They included a population-based sample of 106 adults who fulfilled the 2013 American College of Rheumatology/European League Against Rheumatism criteria for SSc; they excluded 8 patients who had previously received laser treatment for TAs.
  • They recorded the number of TAs on the whole body (total and those >5 mm) and TA distribution in different areas.
  • Using univariate and multivariate linear regression, the relationship with clinical and biological data was studied.

Results

  • As per data, a total of 106 patients (83 [78.3%] women), including 12 with precapillary pulmonary hypertension (PH) were enrolled.
  • Findings suggested the mean (SD) age to be 60.6 (13.5) years.
  • Results demonstrated that telangiectasia distribution on the face was 37.2%, on the upper limbs was 33.2%, including 26.4% on the hands, 28.1% on the trunk, including 17.1% for the upper part of the trunk, and 1.5% on the lower limbs.
  • Experts noted that in analysis using the multivariate linear regression model, the whole-body TA number was independently related to male sex (percentage change, 144.4%; 95% CI, 7.5% to 455.9%;P=.03), PH (162.8%; 95% CI, 5.6% to 553.8%;P=.04), history of pulmonary embolism (336.4%; 95% CI, 39.0% to 1270.1%;P=.01), glomerular filtration rate (-1.6%; 95% CI, -3.2% to -0.1% per 1-mL/min/1.73 m2 increase;P=.04), and soluble endoglin level (28.2%; 95% CI, 1.2% to 62.5% per 1-ng/mL increase;P=.04).
  • They found that for the TA number on the whole body (0.77; 95% CI, 0.57 to 0.88), on the hands and face (0.81; 95% CI, 0.57 to 0.91), and on the hands (95% CI, 0.77; 95% CI, 0.57 to 0.89), receiver operating characteristic analyses assessing the ability of TAs to identify the presence of PH revealed that the area under the curve was significant.

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