Importance of Screening Skin Pigmentation Disorders in Systemic Sclerosis

Screenings for skin pigmentation disorders in patients with systemic sclerosis (SSc) may be useful in identifying digital ulcer risks, according to a study published in the Journal of the American Academy of Dermatology.

A single center retrospective study, conducted from January 2012 to March 2017, included 239 patients with SSc, 61 men and 178 women. The mean age was 59.7 years. Of these patients, 70.7% were classified as limited cutaneous SSc, 29.3% as diffuse cutaneous SSc, and 14.6% of these patients exhibited symptoms suggestive of overlap syndrome.

The incidence of skin pigmentation in participants was 36.8% (n=88/239). Of these, 58 developed hyperpigmentation and 35 developed hypopigmentation. In addition, 68.2% of patients (n=60/88) had a phototype II to III, and 30.7% (n=27/88) had a phototype IV to VI. Researchers also found a significant connection between diffuse hyperpigmentation and digital ulcers (P =.005), which is associated with SSc vascular involvement.

Study results suggest a strong relationship between diffuse hyperpigmentation and digital ulcers. Researchers concluded that “screening for hyperpigmentation disorders could be useful in the management of SSc patients, both as a diagnostic tool when faced with early undifferentiated symptoms and as a marker to identify patients who are most at risk of developing digital ulcers and/or vascular involvement.”

Reference

Leroy V, Henrot P, Barnetche T, et al. Association of skin hyperpigmentation disorders with digital ulcers in systemic sclerosis: analysis of a cohort of 239 patients [published online August 6, 2018]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2018.07.033