Fatores prognósticos na Esclerodermia localizada e sistêmica: uma revisão integrativa.

Giovanna Cunha Carlini; Debora  Estella Soares Silva Bucci; Beatriz de Carvalho Souza; Samuel Fernandes Maia

doi:10.53843/bms.v9i13.714

Authors

Giovanna Cunha Carlini Centro Universitário São Camilo
Debora Estella Soares Silva Bucci Centro Universitário São Camilo
Beatriz de Carvalho Souza Centro Universitário São Camilo
Samuel Fernandes Maia Centro Universitário São Camilo

DOI:

https://doi.org/10.53843/bms.v9i13.714

Keywords:

diagnóstico, diagnosis

Abstract

Introduction: Scleroderma is a rare connective tissue disease that can involve subcutaneous tissue, muscles and internal organs in its systemic form. This review aims to investigate the factors that affect its prognosis and diagnosis, aiming for better results. Methodology: This article is an integrative review and the descriptors established on the Health Descriptors (DeCS) platform were “localized scleroderma”, “diagnosis” and “prognosis”. Regarding the platforms, the chosen ones were: Virtual Health Library (VHL), Latin American and Caribbean Literature in Health Sciences (LILACS) and ‘National Library of Medicine’ (PUBMED). Results: 22 articles were analysed, 8 of them read in full and selected to compose the analysis of this study. The remaining 14 were removed mainly because they were systematic reviews or case studies, whereas the selected are mostly descriptive and retrospective. Discussion: Localized or systemic scleroderma presents an increase in adhesion molecules. One of the studies includes e-selectin, marker of the endothelial function, and interleukin 2, an immunomodulator related to the severity and to the surface area affected, being prognostic markers. Another study talks about microRNA, aspiring the control and treatment, such as serum levels of miRNA-181b-5p, miRNA-223-3p, related to poor prognosis. Other researchers found that patients with "ground glass opacity" lung involvement are more responsive to treatment, while calcifications demonstrate the opposite. Even though baseline CRP is an inflammatory marker and tends to decrease with treatment, if persistently increased, it can demonstrate a worse prognosis. About histopathology, lesions on the face and neck have a lower degree of sclerosis compared to those on the torso. Furthermore, recent dissemination, presence of eosinophils and pigmentation are a risk for poor response to treatment. Conclusion: The systemic form of the disease, pulmonary involvement and persistently increased CRP results in more serious outcomes. In the localized form, lesions on the face and neck present a milder degree of sclerosis compared to lesions on the torso.

Metrics

Metrics Loading ...

References

- Wodok-Wieczorek, K., Salwowska, N., Syguła, E., Wodok, A., Wcisło-Dziadecka, D., Bebenek, K., Bergler-Czop, B., & Brzezińska-Wcisło, L. (2018). The correlation between serum E-selectin levels and soluble interleukin-2 receptors with relation to disease activity in localized scleroderma. Postepy dermatologii i alergologii, 35(6), 614–619. https://doi.org/10.5114/ada.2018.77613 DOI: https://doi.org/10.5114/ada.2018.77613

- Kurzinski, K. L., Zigler, C. K., & Torok, K. S. (2019). Prediction of disease relapse in a cohort of paediatric patients with localized scleroderma. The British journal of dermatology, 180(5), 1183–1189. https://doi.org/10.1111/bjd.17312 DOI: https://doi.org/10.1111/bjd.17312

- Wolska-Gawron, K., Bartosińska, J., Rusek, M., Kowal, M., Raczkiewicz, D., & Krasowska, D. (2020). Circulating miRNA-181b-5p, miRNA-223-3p, miRNA-210-3p, let 7i-5p, miRNA-21-5p and miRNA-29a-3p in patients with localized scleroderma as potential biomarkers. Scientific reports, 10(1), 20218. https://doi.org/10.1038/s41598-020-76995-2 DOI: https://doi.org/10.1038/s41598-020-76995-2

-Bauer, E., Fauny, M., Tanguy, M., Albuisson, E., Mandry, D., Huttin, O., Chabot, F., Deibener, J., Chary-Valckenaere, I., & Loeuille, D. (2020). Relationship between calcifications and structural lesions on hand radiography and axial calcifications on CT-scan: A retrospective study in systemic sclerosis. Medicine, 99(43), e22443. https://doi.org/10.1097/MD.0000000000022443 DOI: https://doi.org/10.1097/MD.0000000000022443

- Yoshida, Y., Sugimoto, T., Hosokawa, Y., Suma, H., Kobayashi, H., Ishitoku, M., Kohno, H., Tokunaga, T., Watanabe, H., Mokuda, S., Nojima, T., Hirata, S., & Sugiyama, E. (2022). C-reactive protein and ground-glass opacity as predictors for intractable interstitial lung disease in patients with systemic sclerosis under cyclophosphamide treatment regardless of concomitant glucocorticoids. Modern rheumatology, 32(1), 141–148. https://doi.org/10.1080/14397595.2021.1907014 DOI: https://doi.org/10.1080/14397595.2021.1907014

- Kim, J., Chung, K. B., Lee, Y. I., Kim, J., & Lee, J. H. (2021). Clinical characteristics and histopathologic changes of morphea: A single-center, retrospective study of 137 patients. Journal of the American Academy of Dermatology, 85(1), 105–113. https://doi.org/10.1016/j.jaad.2020.11.006 DOI: https://doi.org/10.1016/j.jaad.2020.11.006

- Zulian, F., Culpo, R., Sperotto, F., Anton, J., Avcin, T., Baildam, E. M., Boros, C., Chaitow, J., Constantin, T., Kasapcopur, O., Knupp Feitosa de Oliveira, S., Pilkington, C. A., Russo, R., Toplak, N., van Royen, A., Saad Magalhães, C., Vastert, S. J., Wulffraat, N. M., & Foeldvari, I. (2019). Consensus-based recommendations for the management of juvenile localised scleroderma. Annals of the rheumatic diseases, 78(8), 1019–1024. https://doi.org/10.1136/annrheumdis-2018-214697 DOI: https://doi.org/10.1136/annrheumdis-2018-214697

- Kashem, S. W., Correll, C. K., Vehe, R. K., Hobday, P. M., Binstadt, B. A., & Maguiness, S. M. (2018). Inflammatory arthritis in pediatric patients with morphea. Journal of the American Academy of Dermatology, 79(1), 47–51.e2. https://doi.org/10.1016/j.jaad.2018.03.005 DOI: https://doi.org/10.1016/j.jaad.2018.03.005