title: Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry.
abstract: OBJECTIVE
  Digital ulcers (DUs) are frequent manifestations of systemic scleroderma (SSc). This study assessed functional limitations due to DUs among patients enrolled in the Digital Ulcer Outcome (DUO) Registry, an international, multicentre, observational registry of SSc patients with DU disease.
  
  
  METHODS
  Patients completed at enrolment a DU-specific functional assessment questionnaire with a 1-month recall period, measuring impairment in work and daily activities, and hours of help needed from others. Physician-reported clinical parameters were used to describe the population. For patients who completed at least part of the questionnaire, descriptive analyses were performed for overall results, and stratified by number of DUs at enrolment.
  
  
  RESULTS
  This study included 2327 patients who completed at least part of the questionnaire. For patients with 0, 1-2, and ≥3 DUs at enrolment, mean overall work impairment during the prior month among employed/self-employed patients was 28%, 42%, and 48%, respectively. Across all included patients, ability to perform daily activities was impaired on average by 35%, 54%, and 63%, respectively. Patients required a mean of 2.0, 8.7, and 8.8 hours of paid help and 17.0, 35.9, and 63.7 hours of unpaid help, respectively, due to DUs in the prior month. Patients with DUs had more complications and medication use than patients with no DUs.
  
  
  CONCLUSIONS
  With increasing number of DUs, SSc patients reported more impairment in work and daily activities and required more support from others.
authors.affiliation: Department of Internal Medicine, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France. loic.guillevin@cch.aphp.fr
authors.forename: Loïc
authors.initials: L
authors.lastname: Guillevin
authors.forename: Elke
authors.initials: E
authors.lastname: Hunsche
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Denton
authors.forename: Thomas
authors.initials: T
authors.lastname: Krieg
authors.forename: Barbara
authors.initials: B
authors.lastname: Schwierin
authors.forename: Daniel
authors.initials: D
authors.lastname: Rosenberg
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D017281:Cost of Illness; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005385:Fingers / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data; D012595:Scleroderma, Systemic / Q000473:pathology / Q000503:physiopathology*; D057566:Self Report; D012883:Skin Ulcer / Q000473:pathology / Q000503:physiopathology*