Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

Depression and quality of life in patients with chronic wounds: ways to measure their influence and their effect on daily life

R Renner, C Erfurt-Berge Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany Abstract: Depression is a very common comorbidity in patients with chronic wounds. At least 30% of those patients suffer from depressive symptoms or anxiety. To measure impairment on daily life, different quality of life (QoL) questionnaires can be used as well as specialized questionnaires to evaluate different levels of depression. In this review, we present some of the current measurement tools and effects of depression on QoL. Depression is often associated with wound duration, odor of wounds, and furthermore with pain and immobility. On the other hand, depression might reduce wound healing itself via psychoimmunological effects. QoL, in general, is reduced in patients with chronic wounds, but especially in the case of pain, immobility and older age, and sometimes independent to wound status (healed or active). Treating medical and health care personnel should establish depression and QoL questionnaires in daily practice and should consider the psychological health of their patients as part of their treatment. Keywords: quality of life questionnaire, depression assessments, pain, chronic wounds, anxiety, depressio