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2.
Artigo em Inglês | MEDLINE | ID: mdl-31115358

RESUMO

BACKGROUND: The collagen vascular disorders, particularly systemic sclerosis, dermatomyositis, systemic lupus erythematosus and mixed connective tissue disorder, are often characterized by microangiopathic abnormalities of the nail folds. Nail fold dermoscopy is a well-established technique to assess these vascular changes. AIMS: To evaluate finger nail capillary vascular abnormalities by dermoscopy and their correlation with cutaneous and systemic involvement in the patients of collagen vascular disorders. METHODS: This was a cross-sectional study involving patients of collagen vascular disorders presenting to Government Medical College, Amritsar over a period of 2 years. Nail fold dermoscopy was done in these patients and correlated with cutaneous and systemic involvement. Statistical analysis was done using SPSS 17.0 version. RESULTS: A total of 30 patients were enrolled in the study. Sixteen (53.3%), 11 (36.7%) and 3 (10%) patients of systemic sclerosis, systemic lupus erythematosus and mixed connective tissue disorder, respectively were included for nail fold dermoscopy. The commonest change recorded in our study was dilated capillaries in 21 (70%) patients, followed by capillary dropouts in 17 (56.7%) patients and avascular areas in 16 (53.3%) patients. Of 17 patients presenting with sclerodactyly, active, early and late patterns were seen in 7 (41.2%), 2 (11.8%) and 7 (41.2%) patients, respectively. Out of 13 patients with respiratory involvement, active, early and late patterns were seen in 1, 1 and 7 (53.8%) patients, respectively (P value = 0.004). LIMITATIONS: Owing to lesser number of patients in our study, it is difficult to draw conclusive recommendations, and more studies with a larger sample size are required. CONCLUSION: Dermoscopy is a valuable tool not only to diagnose collagen vascular disorders but also for prognostication by correlating with systemic involvement.


Assuntos
Capilares/diagnóstico por imagem , Doenças do Tecido Conjuntivo/diagnóstico por imagem , Dermoscopia , Angioscopia Microscópica , Unhas/irrigação sanguínea , Adolescente , Adulto , Idoso , Doenças do Tecido Conjuntivo/complicações , Estudos Transversais , Dermoscopia/métodos , Feminino , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Doença Mista do Tecido Conjuntivo/diagnóstico por imagem , Doença de Raynaud/etiologia , Doenças Respiratórias/etiologia , Escleroderma Sistêmico/diagnóstico por imagem , Adulto Jovem
4.
Indian J Dermatol Venereol Leprol ; 83(6): 677-682, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29035287

RESUMO

BACKGROUND: Systemic sclerosis is a multisystem disorder characterized by microangiopathy, dysregulation of the immune system and massive deposition of collagen in the connective tissue of the skin, blood vessels and various internal organs. Although the mortality from renal crises has dropped significantly due to the use of angiotensin-converting enzyme inhibitors, cardiac and pulmonary involvement accounts for significant morbidity and mortality. We studied 28 patients with systemic sclerosis at Gandhi Medical College and Hospital, Hyderabad, over a period of two years for cardiopulmonary involvement. AIM: The aim of this study was to analyze the cardiopulmonary involvement in systemic sclerosis. METHODS: All patients with systemic sclerosis attending the dermatology outpatient department were included in the study. The diagnosis of systemic sclerosis was made based on the American Rheumatology Association criteria, and was further confirmed by skin biopsy and serological investigations. X-ray chest, electrocardiogram, two-dimensional ECHO, high-resolution computed tomography chest, pulmonary function tests and bronchoalveolar lavage were done to evaluate cardiopulmonary involvement. OBSERVATIONS: Out of 28 patients, 17 had diffuse systemic sclerosis and 11 had limited systemic sclerosis. Mean duration of symptoms was 2.9 years. Abnormalities in chest X-ray were found in 16 patients. Pulmonary function tests showed a restrictive pattern in 23 patients. High-resolution computed tomography of the chest showed evidence of interstitial lung disease in 21 patients, while five patients each had pleural effusion and cardiomegaly. Bronchoalveolar lavage showed different cellular patterns such as neutrophilia, eosinophilia and lymphocytosis. Pulmonary arterial hypertension was observed in seven patients and isolated pulmonary arterial hypertension in two patients. Electrocardiogram abnormalities were found in twenty patients. Two-dimensional ECHO was abnormal in 17 patients with valvular abnormalities being the most common finding. Overall, pulmonary involvement was observed in 27 patients and cardiac involvement in 17 patients. LIMITATIONS: A small sample size was a limitation of this study. Diffusing capacity of lung for carbon monoxide, and right cardiac catheterization were not done, as these were not available at our centre. CONCLUSIONS: In our patients, pulmonary involvement was more common than cardiac involvement. Interstitial lung disease and cardiac involvement were more commonly seen in diffuse systemic sclerosis whereas pulmonary hypertension was more frequent in limited systemic sclerosis. Hence, it is important to screen the patients for cardiopulmonary involvement for early diagnosis and treatment and a better prognostic outcome.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Escleroderma Sistêmico/diagnóstico por imagem , Centros de Atenção Terciária/tendências , Adolescente , Adulto , Doenças Cardiovasculares/epidemiologia , Criança , Feminino , Humanos , Pneumopatias/epidemiologia , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Doenças Pulmonares Intersticiais/epidemiologia , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória/tendências , Escleroderma Sistêmico/epidemiologia , Adulto Jovem
5.
Clin Rheumatol ; 36(1): 9-14, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27796661

RESUMO

Acro-osteolysis is an osteolysis of the distal phalanges of the hands and feet and can affect the terminal tuft or the shaft of the distal phalanx (transverse or band acro-osteolysis). It is often associated with distal digital ischemia, digital calcinosis, or severe sensory neuropathy. Acro-osteolysis has been associated with a heterogeneous group of disorders, including occupational activities, infections, rheumatic disorders (systemic sclerosis, psoriatic arthritis), endocrinopathies, genetic disorders, and lysosomal storage disorders. Plain radiography is the gold standard for the detection of acro-osteolysis.


Assuntos
Osteólise/diagnóstico por imagem , Reumatologia/métodos , Acro-Osteólise/diagnóstico por imagem , Falanges dos Dedos da Mão/diagnóstico por imagem , Dedos/diagnóstico por imagem , Síndrome de Hajdu-Cheney/diagnóstico por imagem , Mãos/diagnóstico por imagem , Humanos , Hiperparatireoidismo/diagnóstico por imagem , Isquemia/diagnóstico por imagem , Hanseníase/diagnóstico por imagem , Hanseníase/genética , Doenças por Armazenamento dos Lisossomos/diagnóstico por imagem , Mutação , Doenças Reumáticas/diagnóstico por imagem , Escleroderma Sistêmico/diagnóstico por imagem
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