Alteration of microcirculation is a hallmark of very early systemic sclerosis patients: a laser speckle contrast analysis.
OBJECTIVE
To investigate blood flow and microvascular reactivity by laser speckle perfusion imager (Perimed, Jarfalla) in consecutive patients affected by Raynaud's phenomenon at baseline and following dynamic stimulations.


METHODS
Skin blood flow in the dorsum of the hand was measured at baseline and after cold test and post-occlusive hyperemia test in 56 consecutive subjects affected by Raynaud's phenomenon (RP), 20 primary (PRP) and 36 secondary to systemic sclerosis (SSc). Twenty healthy subjects (HS) were studied as controls.


RESULTS
After cold test, SSc had a significant reduction of blood flow (-58%) as compared to HS (-19%) (p=0.01). Recovery time was significantly higher in SSc (58 minutes) as compared to HS (18 minutes) and PRP (19 minutes) (p=0.006 and 0.0016, respectively). Peak flow after ischaemic test was significantly reduced in SSc (+237%) as compared to PRP (+485%) (p=0.0068). Post-ischaemic hyperemic area under the curve (AUC) was blunted in SSc (79U/sec) compared to PRP (167 U/sec) (p=0.0126). Proximal distal gradient was noticed in 74% of HS, 45% of PRP and 36% of SSc (p=0.01). Homogeneous pattern of flux distribution was significantly different between HS (95%), PRP (80%), and SSc (16%) (p<0.0001). Among SSc patients, a significant difference in ischaemic challenge was shown between patients with early-SSc versus patients with definite-SSc.


CONCLUSIONS
Our preliminary results indicate a clearcut alteration of the dynamic of microcirculation in SSc-RP as compared to PRP and HS. Among SSc patients, early-SSc is a separate entity as compared to established disease.
Department of Musculoskeletal and Skin Diseases, Rheumatology Unit, University of Pisa, Italy. a.dellarossa@ao-pisa.toscana.it
Alessandra
A
Della Rossa
Massimiliano
M
Cazzato
Anna
A
d'Ascanio
Antonio
A
Tavoni
Walter
W
Bencivelli
Pasquale
P
Pepe
Marta
M
Mosca
Chiara
C
Baldini
Marco
M
Rossi
Stefano
S
Bombardieri
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003080:Cold Temperature; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007834:Lasers; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D020678:Microscopic Angioscopy / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D011928:Raynaud Disease / Q000175:diagnosis* / Q000503:physiopathology; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000503:physiopathology; D012867:Skin / Q000098:blood supply; D055815:Young Adult