Skin Manifestations And Its Clinical Significance Of 120 Cases With Systemic Scleroderma

Objective:Through comprehensive observation of Systemic scleroderma patients and further discussion of the correlation between skin lesions and gender, systemic involved, SSc classification, course of disease and autoantibody respectively, the article aims to give a more particular knowledge of systemic scleroderma and provide a reference for early diagnosis, treatment and prognosis to this disease.Methods:The sample data comes from 120 Systemic scleroderma patients in dermatology department of Zhongshan Hospital and scleroderma department of shang hai traditional Chinese and Western medicine Hospital from September 2012 to February 2014. We collected medical history and clinical manifestation of the patients in specialized format which was designed scientifically, carefully observed rash and took photos, and then used SPSS statistical software to process data analysis.Results:There are 120 patients in this survey, among which 21 are male and 99are female. Male:Female=1:4.71. With the youngest of 9 and eldest of 83, the average age of patients is 50.02±14.61 years old, course 1 month to 30 years and 6.36±7.76 years on average. In this group of patients,48.3% of patients had lcSSc and 42.5% dcSSc. Overlap syndrome was diagnosed in 5.8% of patients, while 2.5% had an undifferentiated form. SSc sine scleroderma was present in 0.8% of patients.Among the whole 120 patients, Raynaud’s phenomenon (RP) was found in 118 cases including 106(88.3%)ones with starting performance of Raynaud’s phenomenon (RP). The incidence of skin damage is revealed as follow:96.7% sclerosis of skin,75% skin swelling,56.7% dry skin,62.5% thin lips,64.2% poikiloderma,61.7% angiotelectasis,52.5% ankyloglossia,52.5% radioactive stripe around mouth,47.5% facial masking,40.8% hyperplasia of nail cuticle,44.2% open mouth difficulty, 40.0% gingival atrophy,20.8 depression or ulcer on finger tip,29.2% petechia of nail fold,27.5% claw hand,20.0% finger pulp shrinkage、20.0% shorter with end of the finger and 12.5% ulcer on finger tip.The patient by gender is divided into two groups and find that the incidence of thin lips、angiotelectasis and radioactive stripe around mouth in Female is higher than male.The difference are statistically significant in the two group(P<0.05).According to positive and negative of resistance Scl-70 antibody group, stomach flat shrinkage, a small flat leather hyperplasia, cardiac involvement, pulmonary fibrosis in resisting Scl-70 antibody positive group had a significantly higher incidence of resisting Scl-70 antibody negative groups, statistically significant difference (P<0.01). The ACA group (+) and (-), ACA positive group and ACA negative incidence of skin damage and system involving no statistical significance. In addition,the incidence of facial masking、poikiloderma、hyperplasia of nail cuticle、thin lips、finger pulp shrinkage、 cardiac involvement and pulmonary fibrosis in resisting Scl-70 antibody positive group is higher than ACA positive group,statistically significant difference.DcSSc and IcSSc grouping of SSc,dcSSc patients with poikiloderma, difficulty in opening month, the incidence of cardiac involvement was obviously higher than that of IcSSc patients,statistically 8significant difference (P<0.01). Muscle joint involvement dcSSc group was of high incidence than IcSSc group,statistically significant difference (P<0.05).In accordance with skin rashes and system involvement group, found that capillary expansion, fingertips、ulcer or peri-oral radioactive stripes, oral lip thinning and pulmonary artery high pressure ratio was with higher rates, difference is statistically significant.Sclerosis of skin,skin swelling, tpoikiloderma,depression or ulcer on finger tip,ulcer on finger tip,angiotelectasis, finger pulp shrinkage,pulp defect and radioactive stripe around mouth,thin lips has been in the whole process of SSc. With the duration extension, the incidence of angiotelectasis increased.No improvement after treatment with this group of patients to observe angiotelectasis.Difficult in opening mouth has been in early diagnosis of SSc.It increased in the first three years of the course and drop in 3 to 5 years.It suggested that early difficult in opening mouth can be improved after effective treatment. Shorter with end of the fingers and claw hand usually occur after one year of confirming SSc.Once it happened, It is very difficult to treat well.Sclerosis of skin,skin swelling, tpoikiloderma,angiotelectasis,difficult in opening mouth,thin lips and radioactive stripe around mouth are in the greater incidence of early dcSSc patients.Sclerosis of skin,skin swelling, tpoikiloderma,angiotelectasis and ankyloglossia are in the greater incidence of early IcSSc patients.The incidence of tpoikiloderma and difficult in opening mouth in early dcSSc patients than lcSSc,patients,statistically significant difference.Conclusion:Systemic scleroderma often occurs in women.Its starting performance is frequent Raynaud’s phenomenon.The characteristic skin lesions of systemic scleroderma contain that sclerosis of skin、skin swelling、poikiloderma、 telanggietasia、facial masking (thin lips、radioactive stripe around mouth、sharpening of nose as olecranon、nose atrophy、dorsal nasal such as knife cut、ankyloglossia、 open mouth difficulty)depression or ulcer on finger tip、finger pulp shrinkage、shorter with end of the finger and open mouth difficulty.In addition to sclerosis of skin, open mouth difficulty and poikiloderma can help to judges cure effect.Telanggietasia、 depression or ulcer on finger tip、thin lips and radioactive stripe around mouth may be associated with bad prognosis.